SHM Converge Scientific Abstract ePoster Gallery-Cervical Esophageal Perforation Secondary to Consensual Oral Sex: A Case Report

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This case report describes a rare cervical esophageal perforation caused by consensual oral sex in a 50-year-old woman. Esophageal perforation is a serious condition with mortality up to 20%, and most cases are thoracic and iatrogenic. Cervical injuries are uncommon, and this appears to be the first documented case from consensual oral sex.<br /><br />The patient had May-Thurner syndrome and was taking anticoagulation. After intercourse, she fell, heard a “pop,” and developed immediate throat pain and progressive odynophagia over three days. She initially went to urgent care, where x-rays were normal, then to another hospital where CT of the neck and chest showed air around the esophagus. She was transferred to a quaternary care center, kept NPO, and started on antimicrobials.<br /><br />A barium swallow confirmed a cervical esophageal perforation at C5-C6 with a posterior cervical leak. She underwent operative drainage, debridement, and primary pharyngoesophageal repair. Her course was complicated by a recurrent leak requiring repeat washout and drain repositioning. By postoperative day 25, esophagram showed no leak, and she resumed oral intake.<br /><br />The report emphasizes several lessons: detailed history taking is essential when trauma from sexual activity is not initially suspected; nasopharyngolaryngoscopy may miss injuries beyond the hypopharynx; and imaging such as barium swallow can help localize cervical esophageal injuries. It also highlights that cervical esophageal injuries are generally managed by otolaryngology, while lower injuries may require thoracic surgery or advanced endoscopy. Early recognition, precise localization, and multidisciplinary care are key to good outcomes.

Asset Subtitle

Nicholas T. DiMarino

Meta Tag

Author List Alan A. Kubey, Hayley M. Barker, Joshua M. Riley, Michael J. DiMarino, Nicholas T. DiMarino

Category Clinical Vignettes

Concept Esophageal Injury

Concept Cervical Esophagus

Concept Odynophagia

Concept History Taking

Concept Surgical Intervention

Distinguished Non-Finalist

Presenter Organization Sidney Kimmel Medical College at Thomas Jefferson University

Presenting Author Nicholas T. DiMarino

Track Adult

Keywords

cervical esophageal perforation

consensual oral sex

esophageal injury

odynophagia

barium swallow

CT neck chest

pharyngoesophageal repair

posterior cervical leak

anticoagulation

multidisciplinary care

Esophageal Injury

Cervical Esophagus

Odynophagia

History Taking

Surgical Intervention