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An unusual presentation of thoracic diffuse idiopathic skeletal hyperostosis (DISH) and video-assisted thoracoscopic

Suthipas Pongmanee1, Borvornsake Rojdumrongrattana1, Noparoot Kritworakarn1

  • 1Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.

International Journal of Surgery Case Reports
|April 3, 2022
PubMed

Insights

Diffuse idiopathic skeletal hyperostosis (DISH) rarely causes esophageal issues. Surgical removal of a thoracic spine osteophyte via VATS effectively treated dysphagia and dyspepsia in one patient.

Area of Science:

  • Orthopedics
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier's disease, involves ligament and entheses calcification, primarily affecting the thoracic spine.
  • Esophageal compression from anterior osteophytes in thoracic DISH is uncommon, leading to rare symptoms like dysphagia and dyspepsia.

Purpose of the Study:

  • To report a rare case of symptomatic thoracic DISH causing dysphagia and dyspepsia.
  • To highlight the effectiveness of surgical intervention for this condition.

Main Methods:

  • A 72-year-old male with a 10-month history of dyspepsia and dysphagia was diagnosed with thoracic spine osteophyte compression.
  • The anterior osteophyte at the T9-T10 level was surgically removed using video-assisted thoracoscopic surgery (VATS).

Main Results:

  • The patient experienced significant symptom improvement one year post-surgery.
  • No recurrence of the osteophyte or associated symptoms was observed.

Conclusions:

  • Anterior thoracic osteophytectomy using VATS is an effective treatment for symptomatic thoracic DISH causing esophageal compression.
  • This case represents the first reported instance of successful VATS treatment for thoracic DISH-induced dysphagia and dyspepsia.
Abstract

Keywords:
Anterior thoracic osteophytectomyDISHDiffuse idiopathic skeletal hyperostosisDyspepsiaVideo-assisted thoracoscopic surgery

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