Abstract
Background
Odynophagia can be caused by infective and non-infective inflammatory processes, benign and malignant esophageal disorders such as achalasia, gastro-esophageal reflux disease and carcinoma.
Methods
We described two unusual cases of odynophagia and their individual management.
Results
Case 1 is a 21 year-old Indian man presented with 2 days history of odynophagia after taking doxycycline capsules indicated for acne. An esophagogastroduodenoscopy (OGD) was performed and showed multiple mid esophageal ulcers. Esophageal biopsy taken showed inflammatory ulcer slough with no fungal infection, dysplasia or malignancy. Doxycycline was stopped and patient recovered with complete resolution of odynophagia. Case 2 is a 55 year-old Chinese man presented with 1 day history of odynophagia and severe chest pain after eating a bowl of hot fish soup. A CT Thorax was performed which showed a localised perforation of the right wall of the esophagus with extraluminal gas posterior to the trachea. An urgent OGD was performed and an L-shaped fish bone was removed successfully and an endoclip was applied to close the puncture hole of esophagus. Patient made a full recovery without any mediastinal infection.
Conclusion
Odynophagia from mid esophageal ulcers secondary to doxycycline intake should be recognized and can be easily managed by stopping the antibiotics with complete resolution of the symptom. Fish ingestion leading to sharp bone induced penetrating esophageal injury can be safely managed by endoscopic removal and endoclip application.
Disclosure
All authors have declared no conflicts of interest.
Mediastinal infection after cardiac operation
