A Rare Case of Cervical Esophageal Perforation Caused by a Large Wing-Shaped Fishbone Removed by a Transcervical Approach

Herein, we report a rare case of esophageal perforation caused by a large wing-shaped fishbone. The patient was a female in her forties with mental retardation who presented with a sore throat, fever, and dysphagia and gave a history of having eaten yellowtail fish seven days before. Flexible fiberoptic laryngoscopy revealed a large fishbone emerging from the left piriform sinus and stuck in the cervical esophagus. Cervical computed tomography (CT) revealed a cervical esophageal perforation and blood tests revealed elevation of acute inflammatory markers. The fishbone, which was approximately 4 cm in length, was removed by the transcervical approach, and the esophageal perforation was closed by primary suture. The patient received intravenous antibiotics to prevent abscess formation, could resume oral intake on postoperative day 7, and was discharged from the hospital 14 days after the surgery without any complications. Fishbone ingestion can cause significant complications, including perforation of the esophagus. It is essential to promptly identify a foreign body in the cervical esophagus by CT and remove it immediately by the transcervical approach, which can be lifesaving and is usually associated with only minor postoperative complications.