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Distal esophageal perforation by a fishbone

Case contributed by Domenico Nicoletti
Diagnosis certain

Presentation

Intense epigastric pain radiating to the back after dinner of fish

Patient Data

Age: 60 years
Gender: Male

Right hemidiaphragm up with evidence of subtle transparency in the ipsilateral hemidiaphragm. Normal mediastinum.

Presence of pneumomediastinum with air most noticeable around the distal esophagus.

There is a thin radiopaque foreign body arranged transversely to punctured esophageal wall, referring to a fishbone.

After oral contrast, a small amount of extravasated contrast is seen in the distal esophagus.

Case Discussion

Surgical repair of perforation with raffia.

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