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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
 
BMJ Case Rep. 2010; 2010: bcr09.2009.2270.
Published online Feb 22, 2010. doi:  10.1136/bcr.09.2009.2270
PMCID: PMC3027734
Reminder of important clinical lesson
Paraplegia following oesophagectomy
Navneel Shahi,1 Julius Asante-Siaw,2 and Joseph F K Marzouk3
1Northern General Hospital, Sheffield S5 7AS, UK
2University Hospital Coventry and Warwickshire, Coventry CV2 2DX, UK
3University Hospital Coventry and Warwickshire, Cardio-Thoracic Surgery, Coventry CV2 2DX, UK
Correspondence to Navneel Shahi, dr_navi9/at/yahoo.co.uk
Abstract
We report a rare case of postoperative paraplegia in a patient with carcinoma of the oesophagus following oesophagectomy. Neurological deficit was characterised by loss of sensation from the spinal level T2 down to T6, together with flaccid paraparesis of both lower extremities. This was initially thought to be secondary to an epidural haematoma and a magnetic resonance scan was arranged. This suggested changes consistent with spinal cord infarction from D2 to D6 with no haematoma or abscess. This severe complication was most probably caused by embolisation from an atherosclerotic plaque of the thoracic aorta, as the nature of the surgery requires aortic manipulation. This may have consequently led to occlusion of a significant part of the spinal blood supply. Even though anterior spinal artery syndrome is a well known problem in the operative management of thoracic aortic aneurysms, this complication is extremely rare after oesophagectomy.
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