[Mediastinal abscesses caused by a fish bone]

A 72-year-old man presented with left-sided neck pain after eating fish. A flexible fiberolaryngoscopy showed no signs of fish bone or wounds. At the follow-up two days later the patient had developed fever. Direct laryngoscopy and oesophagoscopy revealed no abnormalities. A computed tomography of the neck and thorax showed subcutaneous emphysema and abscesses in the neck and mediastinum originating from the oesophagus. Treatment included incision of the neck, drainage tubes and broad-spectrum IV antibiotics. Although not found, the cause of perforation is strongly believed to have been a fish bone.