J Med Life Sci > Volume 7(2); 2010 > Article
Journal of Medicine and Life Science 2010;7(2):44-47.
DOI: https://doi.org/10.22730/jmls.2010.7.2.44    Published online December 31, 2010.
자리돔 가시에 의한 식도 천공 및 종격동기종 1예
강동구1, 송현주1, 최은광1, 조유경1, 김흥업1, 송병철1, 정선영2
1제주대학교 의학전문대학원 내과학교실
2제주대학교 의학전문대학원 영상의학과교실
A case of esophageal perforation with pneumomediastinum by a fish bone (Chromis notata) impaction
Dong Gu Kang1, Hyun Joo Song1, Eun Kwang Choi1, Yoo-Kyung Cho1, Heung Up Kim1, Byung-Cheol Song1, Sun Young Jeong2
1Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
2Department of radiology, Jeju National University School of Medicine, Jeju, Korea
Correspondence:  Hyun Joo Song, Email: songhj@jejunu.ac.kr
Abstract
Although esophageal perforation due to foreign body is uncommon, it is a lethal problem that requires careful management because of severe complications such as mediaslinilis, empyema, tracheobronchial fistula and retroperitoneal abscess. A 77-year-old man suddenly developed right upper quadrant pain after eating fish (Chromis notata) in the morning the day before admission. Upper endoscopy revealed a 4 cm-sized fishbone impaction and it was removed by a biopsy forcep. Esophageal perforation was found at the middle esophagus. Chest computed tomography showed pneumomediastinum in the left paraaortic area, paraesophageal area, and retrothyroid area. The patient was treated with total parenteral nutrition and broad spectrum intravenous antibiotics. On the seventh day of admission, he was completely recovered and esophagogram showed no leakage of contrast dye. We report an esophageal perforation and pneumomediastinum by a fishbone (Chromis notata) impaction as popular local dish in Jeju island, which was treated successfully with conservative management.
Key Words: Esophageal perforation; Foreign bodies; Pneumomediastinum
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