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Intern Med ; 58(15): 2173-2177, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-30996160

RESUMO

Cases of foreign body ingestion are encountered relatively often in clinical settings; however, serious complications are rare. In such cases, mediastinal abscess due to esophageal perforation can become a life-threatening complication. Although highly invasive, surgery is often used as the first-line treatment. We herein report the case of a 65-year-old woman who presented with complaints of progressive odynophagia and dysphagia for 2 weeks following a fish meal. Enhanced cervicothoracic computed tomography demonstrated an enhanced round mass with peripheral contrasted margins. The mass was diagnosed as a mediastinal abscess resulting from esophageal perforation caused by a fish bone. Endoscopic ultrasound-guided abscess drainage (EUS-AD) was performed using a nasobiliary drainage tube (NDT). Two weeks later, the abscess had completely disappeared. EUS-AD was safe and effective in this case; furthermore, external drainage using NDT was suitable for this abscess located very close to the upper esophageal sphincter.


Assuntos
Abscesso/terapia , Drenagem/métodos , Perfuração Esofágica/diagnóstico , Perfuração Esofágica/etiologia , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Doenças do Mediastino/terapia , Idoso , Animais , Endossonografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Alimentos Marinhos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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