American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(1), 40-44
DOI: 10.12691/ajmcr-9-1-11
Open AccessCase Report

Chicken Bone Perforation “The Missing Link” in a Bemused Breathless Octogenarian-A Case Report of Endoscopic Revivification

Abhilash Haridas1, , Midhun Ramesh2, Padmavathy Ramadoss2 and Ravi Sreekumaran Nair2

1Sree Gokulam Medical College, and Sree Gokulam GG Hospital, Trivandrum, Kerala State, India

2SK Hospital, Trivandrum, Kerala State, India

Pub. Date: November 04, 2020

Cite this paper:
Abhilash Haridas, Midhun Ramesh, Padmavathy Ramadoss and Ravi Sreekumaran Nair. Chicken Bone Perforation “The Missing Link” in a Bemused Breathless Octogenarian-A Case Report of Endoscopic Revivification. American Journal of Medical Case Reports. 2021; 9(1):40-44. doi: 10.12691/ajmcr-9-1-11


Esophageal perforation is a rare complication of foreign body ingestion. The most common foreign bodies causing esophageal perforation in adults are fish and chicken bones. We present the case of an octogenarian man with mild cognitive impairment presenting with respiratory complaints of dyspnoea and orthopnoea in the emergency room. He had hyponatremia induced confusion in addition to his mild cognitive impairment. The diagnosis for his clinical condition was not evident. Evaluation by imaging detected the "missing link" chicken bone as the cause of esophageal double perforation with mediastinitis and bilateral pleural effusion. Following multidisciplinary discussion, the minimally invasive endoscopic approach was decided as the definitive therapy. After medical stabilization in ICU, he underwent endoscopic retrieval of the foreign body followed by fully covered self-expandable metallic stenting. He recovered well and the stent removed after three weeks. Six months down the lane he is doing well and under neurology follow up for mild cognitive impairment. This clinical case shows the atypical, delayed perplexing presentation of esophageal foreign body in the elderly and the need for individualized treatment decision making for a successful outcome.

esophageal perforation chicken bone cognitive impairment endoscopy

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