Thyroiditis at the Starting Point of a Cervical Esophagus Perforation Due to a Foreign Body

Abstract

Introduction: The ingestion of foreign bodies is a frequent accident in children, representing 70% of all cases of perforation, the esophagus is the most frequent location.

Objective: To describe the clinical manifestations, evolution and treatment of a perforation of the cervical esophagus by a foreign body.

Clinical case report: The case of a 56-year-old female patient with history of hypertension, who had ingested fish with 2 days before, was referred to the emergency room at Matanzas Provincial Hospital, due to dysphagia to solid food associated with angioneurotic edema. She underwent additional tests. She was admitted with antibiotic therapy, steroids and fresh gargles for evaluation 12 hours after performing esophagoscopy with a flexible endoscope and no foreign body was found. She was examined at 12 hours and, as she did not evolve favorable, a rigid esophagoscopy and a simple neck CT scan were performed, finding enlarged thyroid with a collection of pus between the cervical esophagus and the trachea. A left lateral cervicotomy was performed in addition to a jejunostomy.

Conclusion: Early diagnosis and proper treatment are essential for the successful management of these patients. However, the rarity of this condition and its nonspecific presentation leads to a delay in both diagnosis and treatment. Failure to detect a foreign body in the endoscopy does not rule out its presence, therefore, in the face of persistent symptoms, it is necessary to carry out diagnostic imaging tests to assess possible relocation.