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Occult esophageal perforation associated with cervical spine fracture.

A case of surgically confirmed cervical esophageal perforation associated with burst fractures of two cervical vertebral bodies is presented. We also describe a second case in which an incidentally discovered abscess of the cervical region could have been the result of esophageal perforation secondary to spine injury. Both patients had negative positive contrast esophagograms . This complication of cervical spine injury is extremely rare, and diagnosis can be difficult. Cervical esophageal perforation must be considered in the face of unexplained cervical, thoracic, or systemic sepsis and in the presence of an unexplained cervical mass. Severe cervical fracture with or without subluxation seems to constitute the anatomical basis for the entity. The treatment consists of drainage and antibiotics aimed at oral flora. The clinical features, diagnostic tests, and surgical management of this entity are reviewed.