Korean J Med.  2015 May;88(5):555-559. 10.3904/kjm.2015.88.5.555.

A Case of an Esophageal Foreign Body with Iatrogenic Esophageal Perforation Caused by the Gag Reflex

• Lee TI
• Jang JY
• Yoon K
• Um YJ
• Hong S
• Kim JW
• Chang YW

• KMID: 1834043
• DOI: http://doi.org/10.3904/kjm.2015.88.5.555

Abstract

Esophageal foreign bodies are a common clinical problem; they can be removed via endoscopic intervention. However, sharp foreign bodies, such as fish bones, stuck in a physiological or pathological stenosis of the esophagus can sometimes lead to esophageal perforation. This can even lead to fatal complications, such as empyema, mediastinitis, esophago-tracheal fistula, and peritonitis. Consequently, during an endoscopic procedure, special precautions and protective devices are required. Here, we report the case of a 56-year-old woman who presented with an esophageal impacted fish bone with iatrogenic esophageal perforation caused by the gag reflex during endoscopic removal. She was treated successfully with surgery and antibiotics. The case highlights the need for sufficient sedation of the patient and attention by clinicians to achieve successful treatment without complications.

Keyword

Esophageal perforation; Foreign bodies; Sedation

MeSH Terms

Anti-Bacterial Agents
Constriction, Pathologic
Empyema
Esophageal Perforation*
Esophagus
Female
Fistula
Foreign Bodies*
Humans
Mediastinitis
Methods
Middle Aged
Peritonitis
Protective Devices
Reflex*
Anti-Bacterial Agents