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Perforation of esophagus and subsequent mediastinitis following mussel shell ingestion

Il Hwan Park1, Hyun Kyo Lim2, Seung Woo Song2

  • 1Departments of Thoracic and Cardiovascular Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.

Journal of Thoracic Disease
|September 14, 2016
PubMed

Insights

Esophageal perforation from foreign body ingestion is rare in adults. This case highlights a patient with a perforated esophagus due to swallowing a mussel shell, leading to mediastinitis.

Area of Science:

  • Gastroenterology
  • Thoracic Surgery
  • Emergency Medicine

Background:

  • Esophageal perforation is a rare complication, particularly in adults, due to the infrequent incidence of foreign body ingestion.
  • Mediastinitis, a serious infection of the chest cavity, can arise secondary to esophageal perforation.

Observation:

  • A case report details an adult male presenting with painful dysphagia following the accidental ingestion of a mussel shell.
  • Computed tomography (CT) confirmed a foreign body in the esophagus and revealed pneumomediastinum, indicative of perforation.

Findings:

  • The mussel shell fragment was successfully removed via rigid esophagoscopy.
  • Surgical intervention, including explo-thoracotomy, debridement of a mediastinal abscess, and irrigation, was necessary to manage the complication.

Implications:

  • This case underscores the importance of considering foreign body ingestion in the differential diagnosis of esophageal perforation, even in adults.
  • Prompt diagnosis and multidisciplinary management involving endoscopy and thoracic surgery are crucial for favorable outcomes in esophageal perforation with mediastinitis.
Keywords:
Esophageal perforationforeign bodymediastinitismussel shell

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