Cervical esophageal perforation with foreign body lodged in the thyroid gland

A 42-year-old male came to the Emergency Department reporting the sensation of a pharyngeal foreign body associated with dysphagia, fever and cervical swelling over the previous 3 days. A cervical-thoracic computed tomography scan revealed a foreign body perforating and going through the cervical esophagus, reaching the thyroid gland, with extraluminal and intrathyroid gas bubbles; reactive locoregional lymphadenopathies were also observed (Fig. 1).

Fig. 1.

Axial image of cervico-thoracic CT where identifies a foreign body passing through the cervical esophagus reaching the thyroid gland.

A left lateral cervicotomy revealed a double cervical esophageal perforation (approximately 3 cm) on the anterior and posterior sides, traversed by a foreign body (chicken bone) that penetrated the thyroid (Fig. 2). We performed left thyroid lobectomy, primary double-layer suture of both perforations, and a local drain tube was placed.

Fig. 2.

Intraoperative image of lateral cervicotomy left, identifying esophageal perforation in the face before and after. Left recurrent laryngeal nerve tutored with blue vessel loop.