Spontaneous pharyngoesophageal perforations.

We report a case of spontaneous multiple perforations of pharyngoesophagus presenting with odynophagia and chest pain. Computed tomography identified a deep neck infection with necrotizing mediastinitis, and esophagography showed leakage of contrast from the pharyngeal wall, pyriform sinus, and thoracic esophagus. Empiric antibiotics, adequate debridement, and resection of the ruptured esophagus with reconstruction were required for complete resolution of the patient's symptoms. Although the simultaneous multiple perforations involving pharyngoesophagus are rare, clinicians should not neglect its possible occurrence.