Endoscopic removal of esophageal foreign body and drainage of thyroid abscess

This is a 58 year old male who presented to our institution with foreign body sensation after eating fish the night before. Although lateral soft tissue films of the neck demonstrated a linear foreign body, this was missed and the patient was discharged home. One week later, he re-presented with persistent throat pain. A computed tomography scan of the neck demonstrated erosion of the foreign body through the esophageal wall and a rim enhancing collection in the right thyroid lobe. The patient was admitted and broad spectrum antibiotics were started. Using a transoral endoscopic approach the abscess was drained and a 2.0 cm sharp fishbone was successfully removed from a perforation at the esophageal inlet. A nasogastric tube was placed and the patient was kept NPO for 14 days postoperatively while his perforation healed. He had improvement in his symptoms and was stable in follow up.