A CASE OF BILATERAL ESOPHAGEAL PERFORATION CAUSED BY CHICKEN BONE THAT WAS EXTRACTED VIA ENDOSCOPY WITHOUT SURGERY

Abstract

A 40-year-old man presented to the emergency room of our hospital with precordial pain after eating chicken for dinner. Computed tomography showed a high-density linear shadow of 40 mm in length in the lower esophagus. Mediastinal emphysema was noted around the mediastinal tip of the foreign body. The patient was diagnosed with bilateral perforation of the lower esophagus by chicken bone, and was referred to our department. After making preparations for on-site surgical backup, endoscopic removal of the foreign body was attempted. Upper endoscopy showed bilateral perforation of the side walls of the lower esophagus. We attempted to remove the foreign body, which was adjacent to the descending aorta, with a grasping forceps from the left side. The foreign body was pulled into the attachment and extracted without aortic injury. Esophageal perforation was managed conservatively and curatively. The patient was discharged 20 days after endoscopic extraction without surgery. Esophageal perforation may cause severe or fatal complications. A foreign body in the esophagus is often removed surgically. Furthermore, in the case of esophageal perforation by a sharp foreign object, severe bleeding may occur during endoscopic extraction. Therefore, it is necessary to devise a technique for endoscopic extraction.