Extrinsic Esophageal Compression by Cervical Osteophytes in Diffuse Idiopathic Skeletal Hyperostosis: A Contraindication to Transesophageal Echocardiography?. Issue 2 (24th November 2015)

• Record Type: Journal Article
• Authors: Chang, Kevin; Barghash, Maya; Donnino, Robert; Freedberg, Robin S.; Hagiwara, Mari; Bennett, Genevieve; Benenstein, Ricardo; Saric, Muhamed
• Is Part Of: Echocardiography. Volume 33:Issue 2(2016)
• Page Start: 314
• Page End: 316
• Publication Date: 2015-11-24
• Subjects: transesophageal echocardiography -- diffuse idiopathic skeletal hyperostosis -- cervical osteophytes -- esophagus -- compression; Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.13115
• Languages: English
• ISSNs: 0742-2822

Abstract

Abstract : Contraindications to transesophageal echocardiography (TEE) include various esophageal pathologies, but compression of the esophagus by vertebral osteophytes is not listed in the current American Society of Echocardiography guidelines. We report a case of diffuse idiopathic skeletal hyperostosis (DISH) in an 81‐year‐old man who had incidentally been found to have extrinsic esophageal compression by cervical osteophytes prior to a proposed TEE. The incidence of esophageal perforation in patients with DISH and vertebral osteophytes is not well documented. We believe these patients are at increased risk of esophageal perforation during TEE, and thus, TEE may be relatively contraindicated in patients with DISH. Mini‐Abstract: We report a case of diffuse idiopathic skeletal hyperostosis (DISH) in an elderly man in whom extrinsic esophageal compression by cervical osteophytes prevented performance of transesophageal echocardiography (TEE). Compression of the esophagus by vertebral osteophytes is not listed in the current American Society of Echocardiography guidelines as a contraindication to TEE. The incidence of esophageal perforation in patients with DISH and vertebral osteophytes is not well documented. We believe these patients are at increased risk of esophageal perforation during TEE, and thus, TEE may be relatively contraindicated in patients with DISH.