A rare cause of cervicomediastinal cellulitis: Oesophageal perforation case report

• Published in: Annals of medicine and surgery 2021-04, Vol.64, p.102195, Article 102195
• Main Authors: Merzouqi, Boutaina, El Bouhmadi, Khadija, Zouhair, Najib, Oukessou, Youssef, Rouadi, Sami, Abada, Redallah Larbi, Roubal, Mohamed, Mahtar, Mohamed
• Format: Article
• Language: English
• Subjects: Case Report; Cellulitis; Cervical esophagus; Dysphagia; Perforation; Surgery
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102195

Esophageal perforation following an impacted foreign body (FB) is a rare and potentially life-threatening condition. Early clinical suspicion and imaging are important for a targeted management to achieve a good outcome. Endoscopic extraction of esophageal FB is a good and safe treatment alternative while the surgical procedure remains a necessary option for many patients. We present the case of a 50 years old woman, with no relevant medical history, who accidently ingested a chicken bone during a meal causing mild dysphagia. The patient consulted immediately but was reassured after normal clinical examination. We received the patient 9 days later with severe dysphagia and cervicomediastinal cellulitis. The cervical CT scan showed the significant collection and the FB impacted in the cervical esophagus wall. A first endoscopic exploration drained the pus and allowed the placement of a nasogastric tube. However, the removal of the FB required an open cervical surgery with the evacuation of the collection and the suture of the esophageal perforation followed by the placement of a drainage tube. The patient medical state improved rapidly and no further incidents were noted. The diagnosis of esophageal FB should be meticulous in order to avoid such life-threatening complications. •Esophageal perforation secondary to an impacted foreign body is a rare and potentially life-threatening condition.•Early clinical suspicion and imaging are important for a targeted management.•Endoscopic extraction of esophageal foreign body is a good and safe treatment alternative that should be considered first.•Surgical procedure, even more invasive, remains a necessary option for many patients.