Cervical cellulitis and mediastinitis following esophageal perforation：A case report

• Published in: World journal of gastroenterology : WJG Vol. 14; no. 9; pp. 1450 - 1452
• Main Authors: Righini, Christian A, Tea, Basilide Z, Reyt, Emile, Chahine, Karim A
• Format: Journal Article
• Language: English
• Published: United States Department of ENT-HNS,University Medical Center of Grenoble,38043 Grenoble Cedex 09,France 07.03.2008; Baishideng Publishing Group Co. Limited; The WJG Press and Baishideng
• Subjects: Cancer; Case Report; Cellulitis; Cellulitis - diagnosis; Cellulitis - etiology; Esophageal Perforation; Esophageal Perforation - complications; Esophageal Perforation - etiology; Esophageal Perforation - surgery; Foreign-Body Migration; Foreign-Body Migration - complications; Humans; Life Sciences; Male; Mediastinitis; Mediastinitis - diagnosis; Mediastinitis - etiology; Middle Aged; Neck; Neck - pathology; 外科手术; 宫颈蜂窝组织炎; 病例研究; 食管穿孔; Foreign body; Perforation; Surgery; Mediastinitis; Esophagus
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.14.1450

Chicken bone is one of the most frequent foreign bodies （FB） associated with upper esophageal perforation. Upper digestive tract penetrating FB may lead to life threatening complications and requires prompt management. We present the case of a 52-year-old man who sustained an upper esophageal perforation associated with cervical cellulitis and mediastinitis. Following CT-scan evidence of FB penetrating the esophagus, the impacted FB was successfully extracted under rigid esophagoscopy. Direct suture was required to close the esophageal perforation. Cervical and mediastinal drainage were made immediately. Nasogastric tube decompression, broad-spectrum intravenous antibiotics, and parenteral hyperalimentation were administered for 10 d postoperatively. An esophagogram at d 10 revealed no leak at the repair site, and oral alimentation was successfully reinstituted. Conclusion： Rigid endoscope management of FB esophageal penetration is a simple, safe and effective procedure. Primary esophageal repair with drainage of all affected compartments are necessary to avoid life-threatening complications.