Year 2013 / Volume 105 / Number 1
Letter to the Editor
Carlos Fernández-Carrillo, Alberto Herreros-de-Tejada, Clara Salas, Luis Ramos, Cristina Suárez y Luis Abreu

pp. 58-59

Carlos Fernández-Carrillo, Alberto Herreros-de-Tejada, Clara Salas, Luis Ramos, Cristina Suárez y Luis Abreu

Abstract
We present an 88-year-old woman with polymyalgia rheumatica on treatment with oral corticosteroids (prednisone 30 mg b.i.d) who was admitted to our institution because of dysphagia, odynophagia and fatigue in the last two weeks. Some days before admission, the patient had complained of an episode of atypical thoracic pain irradiated to her neck, with a normal cardiologic study. One day after her admission she pre- sented with hematemesis without hemodynamic instability or anemia. An upper endoscopy was performed, showing a par- tially fibrin-covered orifice with an apparently blind end, locat- ed in the cervical esophagus (Fig. 1A). Biopsies from the orifice borders were taken. An esophagogram and a computerized tomography scan were performed (Fig. 1B and C), showing a fistula in the lateral face of the cervical esophagus, in communication with a pseudo-cavity filled with oral contrast (esoph- agogram). The biopsies demonstrated the presence of the char- acteristic cytopathic CMV effect (Fig. 1D).
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Carlos Fernández-Carrillo, Alberto Herreros-de-Tejada, Clara Salas, Luis Ramos, Cristina Suárez y Luis Abreu. Carlos Fernández-Carrillo, Alberto Herreros-de-Tejada, Clara Salas, Luis Ramos, Cristina Suárez y Luis Abreu. 58-59


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