Wang LP, Zhou ZY, Huang XP, Bai YJ, Shi HX, Sheng D. Neck and mediastinal hematoma caused by a foreign body in the esophagus with diagnostic difficulties: A case report. World J Clin Cases 2022; 10(6): 1961-1965 [PMID: 35317134 DOI: 10.12998/wjcc.v10.i6.1961]
Corresponding Author of This Article
Di Sheng, MD, Chief Nurse, Department of Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 1367 Wenyi West Road, Hangzhou 310003, Zhejiang Province, China. shengdihuli@163.com
Research Domain of This Article
Emergency Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Li-Ping Wang, Zhi-Ying Zhou, Xiao-Ping Huang, Yun-Juan Bai, Hai-Xia Shi, Di Sheng, Department of Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Wang LP and Di S contributed equally to this case, both wrote and revised the text; Zhou ZY, Huang XP, Bai YJ, and Shi HX contributed equally in this case report; all were part of the clinical team that treated the patient, and all contributed to the text.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No conflict of interests exists to any of the authors.
CARE Checklist (2016) statement: CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Di Sheng, MD, Chief Nurse, Department of Emergency and Trauma Center, The International Medical Center, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 1367 Wenyi West Road, Hangzhou 310003, Zhejiang Province, China. shengdihuli@163.com
Received: August 15, 2021 Peer-review started: August 15, 2021 First decision: November 6, 2021 Revised: November 16, 2021 Accepted: January 13, 2022 Article in press: January 13, 2022 Published online: February 26, 2022
Abstract
BACKGROUND
Esophageal foreign body (FB) is a common clinical emergency. Clinically, computed tomography (CT) scans are important in the diagnosis of FBs in the esophagus. Here, we report a case of esophageal perforation and cervical hematoma, caused by a FB, whose uniqueness made rapid diagnosis difficult.
CASE SUMMARY
A 42-year-old man was transferred to our hospital with esophageal perforation, which was accompanied by cervical and mediastinal hematoma. CT scans only revealed a black shadow, approximately 2.5 cm in diameter, in the upper esophagus. After multidisciplinary discussion, he was quickly subjected to mediastinal hematoma resection, peripheral nerve compression release, esophageal FB removal and esophagectomy. Eventually, we removed a small crab with a pointed tip from his esophagus.
CONCLUSION
This was an unusual case of occurrence of sharp polygonal esophageal FBs caused by a small crab. Rapid diagnosis of this FB was difficult, mainly due to its translucent nature. Occurrence of sharp FBs, with cavities that sometimes only appear as black shadows on CT scans, can easily be mistaken for esophageal lumens. More attention should be paid to such sharp polygonal FBs.
Core Tip: Esophageal foreign body (FB) is a common clinical emergency, a man suffered a sharp polygonal FB caused by the small crab. The FB in this patient was more difficult to detect on computed tomography because of its translucent nature, which increased the difficulty of rapid diagnosis. This case is rare and We should pay more attention at the sharp polygonal foreign body.
