Abstract
A 44-year-old woman who had higher brain dysfunction as a sequela due to an injury to the head developed into argument with her mother during a meal and got excited. Then she ate a fish (sea bream) with the bones and head, which was poached with soy sauce and sugar. Soon she felt that something was wrong at the pharynx and she became to be incapable of ingesting solid foods. Three days later she presented to our hospital. Cervical soft X-ray radiography and CT scan revealed a L-shaped fish bone to have penetrated the right side of the cervical esophagus. Endoscopic extraction of the fish bone was attempted, but we determined that the extraction was impossible due to its poor movability. Since abscess formation was absent at the perforated site, the operation was performed only to remove the foreign body. After mobilized the left lobe of the thyroid, we performed transcervical esophagotomy at the left side of the cervical esophagus which was contralateral to the perforated site to remove the fish bone. After the removal of the fish bone, the incision was immediately sutured and a drain was placed close to there. The removed fish bone was a jaw's bone of sea bream. After the operation, the patient was given cefazolin sodium for 7 days, and started to drink on the 6th and to have meals on the 7th postoperative day. The drain was removed on the 8th day and she was discharged from the hospital on the 10th day after the operation without complications.
