Emergency Radiology

, Volume 1, Issue 2, pp 107–109 | Cite as

Epidural abscess resulting from traumatic esophageal rupture secondary to a flexion-extension injury

Delayed presentation and diagnosis
  • John F. Healy
  • Michael Fishman
  • Kenneth Croutch
Case Report


An epidural abscess developed several weeks after a traumatic esophageal rupture secondary to a reported flexion-extension injury in a restrained back seat passenger in a motor vehicle accident. Chest radiograph and an Indium study suggested the possibility of a posterior mediastinal abscess. Chest computed tomography (CT) also noted epidural abscess and osteomyelitis, which were confirmed by magnetic resonance imaging (MRI). Diagnosis was delayed significantly by underinterpretation of both chest and CT findings. Obvious positive findings (lower lobe infiltrate on chest radiograph and posterior mediastinal abscess on CT) were noted, but more subtle and very important findings of superior mediastinal widening and extra pulmonary gas bubbles on the chest radiograph and extradural disease displacing the spinal cord on CT were not described. We can find no previously reported case of esophageal rupture associated with flexion-extension injury of the neck. It is also extremely rare for esophageal rupture to remain asymptomatic for more than several hours.

Key Words

Epidural abscess Spine Esophagus Trauma Osteomyelitis Whiplash Flexion-extension injury 


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Copyright information

© the American Society of Emergency Radiology 1994

Authors and Affiliations

  • John F. Healy
    • 1
  • Michael Fishman
    • 1
  • Kenneth Croutch
    • 1
  1. 1.University of CaliforniaSan Diego

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