Localized perforation of the esophagus due to a metallic stent is a well recognized complication. This is usually complicated by a mediastinum or paravertebral abscess as in this case often containing very unusual upper GIT organisms (may be multiple). The infection is often indolent but ultimately progressive and in this case has extended into the vertebral column via the disc space causing the bodies to collapse. Infection has then entered the epidural space. This usually has a fateful outcome.