Two Cases of Foreign Bodies in the Hypopharynx and Esophagus Leading to Abscess Formation

Abstract

In this study, we report two cases of foreign bodies in the hypopharynx and esophagus leading to abscess formation due to delayed diagnosis caused by psychiatric and neurological disorders. Case 1 was a 40-year-old woman with a history of schizophrenia and mental retardation. Six days after the onset of dysphasia, a CT scan revealed a chicken bone in the esophagus, causing abscess formation, and the patient was referred to our hospital. In an emergency operation, the chicken bone lodged from the hypopharynx to the cervical esophagus was removed transorally, and transcervical drainage was performed. After swallowing rehabilitation, the patient was discharged 51 days later. Case 2 was a 75-year-old man with untreated dementia. He had left neck pain after eating boiled sea bream, but his general practitioner made no diagnosis. A CT scan on the fifth day of onset showed that a fish bone had migrated outside the hypopharyngeal cavity. The patient was referred to our hospital, and transoral removal of the fish bone and drainage of the abscess were performed. However, the patient exhibited decreased swallowing function and was transferred to another hospital for rehabilitation. In both of the cited cases, early diagnosis could have prevented abscess formation and prolonged hospitalization. When treating dysphagia with neck pain in patients with psychiatric and neurological disorders, it is necessary to consider the possibility of a foreign body. At the same time, in order to prevent recurrence the patient's family should be educated to avoid giving any foods that may cause a foreign body to lodge.