Endoscopic submucosal dissection for drainage of esophageal abscess with fish bone extraction

Background and Aims: Foreign body ingestion with submucosal penetration presents a challenging clinical scenario. We present a case of successful endoscopic submucosal dissection (ESD) for removing an embedded fish bone with drainage of an associated submucosal abscess. Methods: A 49-year-old woman...

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Bibliographic Details
Main Authors: Abel Joseph, MD, Linda Nguyen, MD, Joo Ha Hwang, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:VideoGIE
Online Access:http://www.sciencedirect.com/science/article/pii/S2468448125001079
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Summary:Background and Aims: Foreign body ingestion with submucosal penetration presents a challenging clinical scenario. We present a case of successful endoscopic submucosal dissection (ESD) for removing an embedded fish bone with drainage of an associated submucosal abscess. Methods: A 49-year-old woman presented with odynophagia after fish bone ingestion. Computed tomography scan identified a linear density in the upper esophagus. After an initial negative esophagogastroduodenoscopy, a repeat procedure revealed a submucosal abscess. The ESD technique was used to drain the abscess and retrieve the fish bone. Results: The fish bone was successfully removed using ESD technique without immediate or delayed adverse events. Postprocedure management included antibiotics, proton pump inhibitor therapy, and dietary modification. Follow-up esophagram confirmed absence of fistula or abscess. Conclusions: This case demonstrates the importance of careful endoscopic assessment and the utility of ESD technique in managing superficial esophageal abscesses. ESD is a safe and effective technique for removing embedded esophageal foreign bodies within the submucosa.
ISSN:2468-4481