Esophageal Perforation and Fistulization After Ingestion of Multiple Foreign Bodies: A Case Report.

Esophageal perforation is a life-threatening condition associated with high morbidity and mortality, particularly when diagnosis or treatment is delayed. Foreign body ingestion is a known cause of esophageal injury and may result in severe complications requiring surgical intervention. We report the clinical course and therapeutic management of a young adult who developed cervical esophageal perforation after deliberate ingestion of multiple foreign bodies associated with acute cocaine intoxication and self-induced emesis. The patient presented with cervical pain, extensive subcutaneous emphysema, and pneumomediastinum and underwent exploratory cervicotomy with primary esophagorrhaphy. The postoperative course was complicated by hemopneumothorax requiring thoracoscopic drainage and subsequent esophageal fistulization, which was successfully managed conservatively. This case highlights the diagnostic challenges, multidisciplinary decision-making, and potential complications associated with esophageal perforation secondary to deliberate foreign body ingestion in high-risk patients.