부산대학교 도서관

Here, we report a case of esophageal perforation due to accidental ingestion of a chopstick that was treated conservatively. A 72-year-old woman, who had been hospitalized because of dementia and epilepsy, ingested a chopstick accidentally which was quickly removed manually. The next day, she suffered from fever and dyspnea. A chest X-ray image revealed pneumothorax and pleural effusion on the left, and she was transported to our hospital. Drainage of the left thoracic cavity was performed immediately and the discharge was digestive juices, so her condition was diagnosed as esophageal perforation. CT revealed pneumothorax, pyothorax, and mediastinal abscess due to esophageal perforation. We performed upper gastrointestinal endoscopy and detected the perforation site in the upper esophagus 18 cm from the incisors. The hole was closed with endoscopic clips. Furthermore, we inserted a drain tube into the mediastinal abscess percutaneously using CT guidance. Thereafter, her condition improved, and she resumed oral intake on the 16th hospital day, and was discharged on the 50th hospital day. Our experience suggests that there are some cases of esophageal perforation which can be treated conservatively using appropriate interventions even if the patient shows severe symptoms.