Gastric intramural hematoma caused by argon plasma coagulation: treated with endoscopic incision and drainage (with videos)

Abstract

Anterior cervical plate implantation is commonly performed. Esophageal perforation from plate displacement occurs in approximately 2% of cases.1 Dysphagia, neck abscess, and/or aspiration pneumonia occurs weeks to years after surgery. Recognition of this complication is critical because mortality can be as high as 20%.2 Causes of esophageal perforation after spinal fixation include screw migration and chronic pressure necrosis by the cervical plate.1,3 Endoscopy allows direct inspection of the esophgus for exposed intraluminal hardware. CT of the neck is elpful to assess for neck abscess and esophagography to valuate for esophageal leakage. Treatment usually inolves hardware removal and reconstruction of the esophaus. Uncomplicated esophageal injuries and contained leaks ay be treated conservatively with antibiotics and extraoral eedings. Surgery is necessary for neck abscess, recurrent spiration pneumonia, and sepsis.2 Prior radiation-induced damage to the esophagus may contribute to erosion and perforation by the cervical plate. d