On October 30, Bach Mai Hospital reported the unusual case involving a 45-year-old man from Ninh Binh Province.

The incident occurred on the morning of October 21, when the man suddenly experienced throat pain while eating instant noodles. He sought help at a private clinic, where doctors detected a foreign object in his esophagus. He was transferred to Bach Mai Hospital's Ninh Binh facility for emergency treatment that afternoon.

On admission, the patient was conscious but suffering from throat pain, chest tightness and difficulty speaking due to the pain. His heart rate was elevated. X-rays revealed extensive air leakage into the mediastinum, the space between the lungs, and the base of his neck on both sides.

A CT scan subsequently identified a razor blade lodged inside his esophagus at the level of the second and third thoracic vertebrae. The surrounding esophageal wall was thickened and swollen, with air detected in the mediastinum and around the base of the neck.

The hospital immediately convened a multidisciplinary consultation. As initial examinations showed no evidence of blood vessel damage, specialists agreed to remove the blade endoscopically under general anesthesia in an operating room.

The greatest challenge was the blade's sharp edges and its position. It had penetrated both opposing walls of the upper third of the esophagus, a particularly narrow section that left little room for maneuvering the endoscope. Even a minor mistake during removal could have caused further injury.

During the procedure, doctors located the blade approximately 20cm from the patient's upper teeth, embedded deeply in both esophageal walls. After removing it, they discovered two opposing tears in the muscular layer, each measuring about 2cm. One side had been perforated, allowing air to escape.

The medical team successfully removed the blade and treated the perforation that night. The endoscopic procedure lasted approximately 90 minutes and was completed around midnight.

At the same time, gastrointestinal surgeons performed a gastrostomy and jejunostomy, creating openings into the stomach and small intestine to provide nutritional support while the patient's esophagus recovered.

Doctors warned that esophageal perforation caused by sharp foreign objects is extremely dangerous. Without prompt diagnosis and treatment, it can lead to mediastinitis or a mediastinal abscess, both potentially life-threatening complications.

Once such complications develop, treatment becomes considerably more complex. Patients may require major surgery, prolonged intensive care and could even face the risk of death.

Phuong Thuy