Abstract
We encountered a patient with an esophageal ulcer due to rupture of an abscess arising from spinal caries, and followed up the changes of endoscopic findings. The patient was a 61-year-old man. An ulcer was observed on the right anterior wall of the middle part of the esophagus and superficial esophageal carcinoma was suspected, but malignancy was not proved histopathologically, The ulcer spontaneously improved one month later, and a fistula developed. Subsequent examination showed spinal caries affecting the second and third thoracic vertebrae in association with gravitation abscess. Thus, a diagnosis was made as ulceration due to rupture of the esophagus by a tuberculous abscess, and antituberculous therapy was started. The fistula was completely closed after treatment. Removal of the infectious focus and anterior fixation were performed for the spinal caries. At presest, the patient remains in a good condition at 14 months after operation. Only two cases of esophageal ulcer due to spinal caries have been reported so far in Japan. In the present case, the esophageal ulcer was similar to a depressed esophageal carcinoma. This is the first case which was been able to follow up the course of reduction in ulcer size, fistula and scar formation.
