Spontaneous cervical esophageal perforation: a case report
Related Experiment Video
Updated: Oct 31, 2026

Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
Published on: November 15, 2024
Bourhan Alrayes1, Samer Al Sawalhi2, Tala Abu Baker3
1UHCW, Walsgrave, Coventry UK.
Abstract:
Spontaneous cervical esophageal perforation (SCEP) is an infrequently reported but potentially fatal surgical emergency. Early recognition is crucial to prevent life-threatening complications. A 20-year-old previously healthy male presented with recurrent vomiting and nausea. Examination revealed left-sided neck tenderness, subcutaneous emphysema, and dysphonia. Laboratory studies showed leucocytosis (white blood cell count (WBC) 14 × 109/L) and C-reactive protein level of 210 mg/L. Upper endoscopy identified two full-thickness cervical esophageal perforations. Contrast-enhanced computed tomography (CT) of the neck and chest demonstrated extraluminal air and localized contrast leakage without mediastinal involvement. The patient underwent immediate surgical exploration with two-layer primary repair reinforced using an omohyoid muscle flap and placement of surgical drains. Recovery was uneventful, and a water-soluble swallow study performed six days postoperatively confirmed the absence of leakage. As SCEP is rarely encountered, a high index of suspicion, prompt imaging, and early surgical repair with adequate drainage are critical to achieving favorable outcomes.
Related Concept Videos
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus.
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Esophageal Achalasia
Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Hiatal Hernia
