Abstract
We report a case of a submucosal abscess of the esophagus that required differentiation from a mediastinal abscess. A 48-year-old man presented with a chief complaint of fever and sore throat. He did not remember swallowing a foreign body, and his oral cavity showed no signs of inflammation. Contrast-enhanced computed tomography showed a low density area with enhancement in the mediastinum, especially around the esophageal wall. We planned to perform surgical drainage with the intention of performing intraoperative endoscopy from the beginning. We performed surgical drainage through a left cervical oblique incision; however, there was no exudate obtained from the mediastinal space. Despite the reported absence of accidental ingestion of a foreign substance, intraoperative endoscopy was performed that revealed a laceration in the esophageal mucosa 24 cm from the incisors. We diagnosed it as a submucosal abscess of the esophagus and prescribed parenteral antibiotics. Submucosal abscess of the esophagus can occur even in the absence of awareness of a foreign body ingestion or oral infection. In case that the abscess was not localized clearly within the outer membrane of the esophagus, the coincidental mediastinal drainage via a cervical incision and intraoperative endoscopy seemed to be useful.
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Dr. Yoshida reports receipt of grants, personal fees and non-financial support from EA Pharma Co., Ltd., Sanofi, Yakult Honsha Co., Ltd., Chugai Pharmaceutical Co., Ltd., Taiho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Daiichi Sankyo Co., Ltd., Ono Pharmaceutical Co., Ltd., Merck Serono Co., Ltd., and Novartis Pharma K.K.; and grants from Kyowa Hakko Kirin Co., Ltd. outside of the submitted work. Dr. Tanaka reports receipt of grants from Daiichi Sankyo Co., Ltd. outside of the submitted work. Other authors have no conflict of interest to disclose. The funding source had no role in the design, practice, or analysis of this study.
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Ojio, H., Tanaka, Y., Sato, Y. et al. A case of submucosal abscess of the esophagus mimicking a mediastinal abscess. Clin J Gastroenterol 14, 402–406 (2021). https://doi.org/10.1007/s12328-020-01299-x
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DOI: https://doi.org/10.1007/s12328-020-01299-x