Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2019; 7(23): 4130-4136
Published online Dec 6, 2019. doi: 10.12998/wjcc.v7.i23.4130
Rigid esophagoscopy combined with angle endoscopy for treatment of superior mediastinal foreign bodies penetrating into the esophagus caused by neck trauma: A case report
Dong Wang, Chao-Bing Gao
Dong Wang, Chao-Bing Gao, Department of Otorhinolaryngology Head and Neck, First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Author contributions: Wang D and Gao CB collected the patient’s clinical data and wrote the paper; Gao CB designed the report; Wang D and Gao CB were the otolaryngology head and neck surgeons of the patient, reviewed the literature, and participated in the manuscript drafting; all authors issued final approval for the version to be submitted.
Supported by Natural Science Foundation of Anhui Province, No. 1608085MH189; Anhui Province Academic and Technical Leaders Reserve Candidates Grant, No. 2018H160.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: 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/
Corresponding author: Chao-Bing Gao, MD, Doctor, Department of Otorhinolaryngology Head and Neck, First Affiliated Hospital of Anhui Medical University, No. 218, Jixi Road, Hefei 230022, Anhui Province, China. gcb110011@163.com
Telephone: +86-551-62922067 Fax: +86-551-63633742
Received: September 27, 2019
Peer-review started: September 27, 2019
First decision: October 24, 2019
Revised: November 14, 2019
Accepted: November 20, 2019
Article in press: November 20, 2019
Published online: December 6, 2019
Abstract
BACKGROUND

Herein, we report a case in whom two foreign bodies entered the upper mediastinal cavity from the cervical root and subsequently the esophagus. Surgery is the preferred treatment method, and operational procedures depend on the size and location of the foreign body relative to the mediastinal vessels. Rigid esophagoscopy combined with angle endoscopic surgery was selected to avoid surgical trauma and complications.

CASE SUMMARY

A 63-year-old male patient with a 6-mo old history of neck trauma presented with a black-brown foreign body in the lateral wall of the esophagus. Neck and chest computed tomography (CT) revealed that two superior mediastinal foreign bodies penetrated the esophagus diagonally. We removed two foreign bodies through an esophagoscope. Owing to the rigid working channel of esophagoscope and good exposure of endoscope, the risk of injury to the adjacent vital tissues was minimized. Postoperative comprehensive therapies, including antibiotic administration and nutritional support, resulted in a prompt postoperative recovery. Postoperative CT confirmed the absence of a residual foreign body and neck and chest infections. In addition, upper gastrointestinal angiography and gastroscopy revealed the absence of an evident esophageal perforation. The patient received an oral diet and did not experience any complication at the time of discharge from the hospital.

CONCLUSION

Rigid esophagoscopy combined with angle endoscopy is an effective, minimally invasive treatment for penetrating neck injuries.

Keywords: Superior mediastinal, Esophagoscope, Esophageal perforation, Case report

Core tip: In this case, we report a 63-year-old male patient with a history of neck trauma who presented with a black-brown foreign body in the lateral wall of the esophagus. Neck and chest-computed tomography showed that two superior mediastinal foreign bodies penetrated the esophagus diagonally. We performed a rigid esophagoscopy combined with angle endoscopic surgery to remove the two foreign bodies. Because of a rigid working channel of the esophagoscope and good exposure of the endoscope, the risk of injury to the adjacent vital tissues was minimized.