Cervicothoracic emphysema after foreign body ingestion - when surveillance is the best strategy
DOI:
https://doi.org/10.34631/sporl.3157Keywords:
Foreign body, Oropharyngeal perforation, Cervicothoracic emphysema, Pneumomediastinum, Conservative medical therapyAbstract
A 58-year-old male patient, admitted to a long-term psychiatric unit because of his history of paranoid schizophrenia, depressive mood and self-harming behaviour. He was referred to the emergency department after accidentally swallowing two dentures, which were subsequently removed. He presented with complaints of anterior neck pain. Physical examination revealed him to be haemodynamically stable and apyretic, with cervical subcutaneous emphysema and oropharynx lacerations. Laboratory tests revealed elevated inflammatory parameters. Both cervicothoracic radiography and computed tomography showed bilateral cervical subcutaneous emphysema and pneumomediastinum with no evidence of foreign bodies. Nasofibrolaryngoscopy revealed lacerations on the posterior wall of the oropharynx with no changes in the hypopharynx or larynx. The conservative medical approach adopted included seven days of empirical intravenous antibiotic therapy, exclusive enteral nutrition via a nasogastric tube and monitoring in the intermediate care unit. He was discharged on the eighth day of hospitalisation with resolution of the oropharyngeal lacerations, emphysema and associated clinical symptoms.
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Copyright (c) 2026 Ana Sofia Paiva, Eduardo Ferreira, João Rosa, Pedro Ponte, Joaquim Amaral, Sofia Decq Mota, Carolina Arede, Ana Raquel Andrade
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