A case of a chopstick stub injury to the lower pharynx and mediastinitis

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 70; no. 8; pp. 2291 - 2294
• Main Authors: NAGASHIMA, Takuya, MOROHOSHI, Takao, GORAI, Atsuo, NAKAZAWA, Kahoko
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2009
• Subjects: chopstick; lower pharynx injury; mediastinitis
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.70.2291

A 34-year-old man complained of throat pain and stated that he had swallowed a chopstick. His chest X-ray was normal, and upper gastrointestinal endoscopy revealed only a laceration at the lower pharynx. Two days later, he developed a high grade fever, cervical swelling, and throat pain. Chest computed tomography (CT) showed mediastinal emphysema and a foreign body. Surgery was done immediately to remove the foreign body and to institute mediastinal drainage. Using a rigid esophagoscope a laceration located at the lower pharynx, was identified ; the laceration was sutured. On the 19th day after surgery, he was discharged from hospital. The mediastinal infection has not recurred. It is difficult to detect a wooden foreign body on plain X-ray. Several authors have reported that CT is the most effective imaging modality in such circumstances. It is important to use appropriate CT window settings and to reconstruct the images using three dimensional CT.