Cervical esophagotomy for foreign body extraction – Case report and comprehensive review of the literature

• A case of cervical esophagotomy for foreign body extraction is described.
• Systematic review of literature shows 29 patients undergoing esophagotomy.
• Complication rates after esophagotomy are justifiable.
• Cervical esophagotomy is a feasible surgical approach.
• A clinical management guideline is provided.

IntroductionEsophageal foreign bodies are an important and serious cause of morbidity and mortality in both children and adults. Due to the possibility of serious complications, i.e. perforation, necrosis, mediastinitis, and fistulation, rapid and accurate diagnostic measures with subsequent therapy are necessary.Case reportWe are reporting a case of a 55-year-old, mentally impaired patient that has swallowed a foreign body, which subsequently became lodged in his esophagus. Due to the fact that endoscopic removal was not possible and there was a high risk of complications such as esophageal perforation or mediastinitis in this case, we performed cervical esophagotomy and successfully extracted the foreign body. The patient showed an uneventful postoperative process and could be discharged on Day 11 after the operation.Comprehensive reviewFurthermore, we performed a systematic review of the literature to identify all studies that described a surgical approach through esophagotomy in cases of foreign body ingestion and found 11 publications describing the cases of 29 patients. These studies reported an overall complication rate of 17.2% and a mortality rate of 0%.ConclusionOur findings suggest that esophagotomy could be a viable approach for the extraction of foreign bodies especially in some cases when endoscopic removal was not successful and the risk of esophageal perforation is high.