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<p>Spontaneous cervical esophageal perforation (SCEP) is an infrequently reported but potentially fatal surgical emergency. Early recognition is crucial to prevent life-threatening complications. A 20-year-old previously healthy male presented with recurrent vomiting and nausea. Examination revealed left-sided neck tenderness, subcutaneous emphysema, and dysphonia. Laboratory studies showed leucocytosis (white blood cell count (WBC) 14 × 10<sup>9</sup>/L) and C-reactive protein level of 210&#xa0;mg/L. Upper endoscopy identified two full-thickness cervical esophageal perforations. Contrast-enhanced computed tomography (CT) of the neck and chest demonstrated extraluminal air and localized contrast leakage without mediastinal involvement. The patient underwent immediate surgical exploration with two-layer primary repair reinforced using an omohyoid muscle flap and placement of surgical drains. Recovery was uneventful, and a water-soluble swallow study performed six days postoperatively confirmed the absence of leakage. As SCEP is rarely encountered, a high index of suspicion, prompt imaging, and early surgical repair with adequate drainage are critical to achieving favorable outcomes.</p>

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Spontaneous cervical esophageal perforation: a case report

  • 期刊论文

  • 发表日期：

    2026年7月24日

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  • Bourhan Alrayes,
  • Samer Al Sawalhi,
  • Tala Abu Baker,
  • Haitham Qandeel,
  • Mahmoud Hilwah

摘要

Spontaneous cervical esophageal perforation (SCEP) is an infrequently reported but potentially fatal surgical emergency. Early recognition is crucial to prevent life-threatening complications. A 20-year-old previously healthy male presented with recurrent vomiting and nausea. Examination revealed left-sided neck tenderness, subcutaneous emphysema, and dysphonia. Laboratory studies showed leucocytosis (white blood cell count (WBC) 14 × 109/L) and C-reactive protein level of 210 mg/L. Upper endoscopy identified two full-thickness cervical esophageal perforations. Contrast-enhanced computed tomography (CT) of the neck and chest demonstrated extraluminal air and localized contrast leakage without mediastinal involvement. The patient underwent immediate surgical exploration with two-layer primary repair reinforced using an omohyoid muscle flap and placement of surgical drains. Recovery was uneventful, and a water-soluble swallow study performed six days postoperatively confirmed the absence of leakage. As SCEP is rarely encountered, a high index of suspicion, prompt imaging, and early surgical repair with adequate drainage are critical to achieving favorable outcomes.