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Case Reports
. 2016 Aug;8(8):E693-7.
doi: 10.21037/jtd.2016.07.88.

Perforation of esophagus and subsequent mediastinitis following mussel shell ingestion

Il Hwan Park  1 , Hyun Kyo Lim  2 , Seung Woo Song  2 , Kwang Ho Lee  2
Affiliations
Case Reports

Perforation of esophagus and subsequent mediastinitis following mussel shell ingestion

Il Hwan Park et al. J Thorac Dis. 2016 Aug.

Abstract

Esophageal perforation is a very rare occurrence because accidental swallowing of foreign bodies is uncommon in adults. Thus, perforation due to swallowing of a foreign body and subsequent development of mediastinitis is rarely encountered by physicians. We experienced such a case and described an adult male patient who had perforated esophagus after accidentally swallowing a mussel shell. The patient visited our emergency department complaining of painful dysphagia for 4 days. A review of history revealed that he consumed a spicy seafood noodle soup containing mussel shells 4 days ago. Computed tomography (CT) of the chest showed the foreign body in the esophagus and pneumomediastinum was identified. We removed the mussel shell fragment using rigid esophagoscopy; explo-thoracotomy, debridement of mediastinal abscess and irrigation were performed.

Keywords: Esophageal perforation; foreign body; mediastinitis; mussel shell.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Computed tomography (CT) of the chest showing a foreign body within the region of esophagus (arrow). The images show abscess in the mediastinum (arrowhead).
Figure 2
Figure 2
Esophageal perforation and mussel shell. (A) Esophagogastroduodenoscopy showing pus and perforation in the proximal esophagus; (B) the extracted piece of mussel shell, 2 cm × 2.5 cm in size, had a rectangular shape with very sharp edges.
Figure 3
Figure 3
Chest computed tomography (CT) showing compression of the trachea and severe mediastinitis.
Figure 4
Figure 4
Esophagography shows no extravasation of contrast dye.
See this image and copyright information in PMC

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