Fatal mediastinitis after routine laparoscopic cholecystectomy

Laparoscopic cholecystectomy is now considered a routine operation with a low complication rate. In this case study, the authors present a laparoscopic cholecystectomy patient who died of masked mediastinitis and concomitant septicemia caused by an unrecognized esophageal perforation after difficult intubation. The authors call attention to the need for early detection of perforating mediastinitis to prevent a lethal outcome from this infrequent but life-threatening condition.