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Journal of Otorhinolaryngology and Facial Plastic Surgery

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Vol. 11 No. 1 (2025)

May 2025

Incidental Discovery of a Hyperdense Esophageal Foreign Body in a Patient with an Unknown Origin of Pneumomediastinum: A Case Report

  • Alper Elez
  • Peter Szekely
  • Robert Klucsai
  • Beata Diosi
  • Balazs Pecsy
  • Laszlo Rovo
  • Adam Perenyi

Journal of Otorhinolaryngology and Facial Plastic Surgery, Vol. 11 No. 1 (2025), 5 May 2025
https://doi.org/10.22037/orlfps.v11i1.49014 Published: 2025-07-15

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Abstract

Background: Esophageal perforations can lead to air entering the mediastinum, resulting in pneumomediastinum and potentially life-threatening complications. Prompt identification and management of foreign bodies are critical in such cases.

Case Presentation: This case presents the incidental discovery of a hyperdense foreign body in the middle two-thirds of a patient’s esophagus, identified on computed tomography (CT) imaging following a prior diagnosis of pneumomediastinum of unknown origin. The foreign body’s potential involvement in the pneumomediastinum presented diagnostic and management challenges for the medical team, as the patient had no prior history of ingesting a foreign object. Further investigation into the patient’s dietary habits, coupled with the CT findings, ultimately revealed that the hyperdense object was bubble gum.

Conclusion: The hyperdense appearance of bubble gum on X-ray and CT scans resembles bone, making it difficult to distinguish without a detailed patient history. Although no causal relationship between the foreign body and the pneumomediastinum was identified, this case underscores the significance of meticulous imaging evaluation and the necessity of considering both prevalent and uncommon etiologies during the diagnostic process.

Keywords:
  • Bubble gum; Foreign Body; Pneumomediastinum.
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How to Cite

Elez, A., Szekely, P., Klucsai, R., Diosi, B., Pecsy, B., Rovo, L., & Perenyi, A. (2025). Incidental Discovery of a Hyperdense Esophageal Foreign Body in a Patient with an Unknown Origin of Pneumomediastinum: A Case Report. Journal of Otorhinolaryngology and Facial Plastic Surgery, 11(1). https://doi.org/10.22037/orlfps.v11i1.49014
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References

Geller, E., Smergel, E.M. Bubble gum simulating abdominal calcifications. Pediatr Radiol 22, 298–299 (1992). https://doi.org/10.1007/BF02019866

Zhong, Q., Jiang, R., Zheng, X., Xu, G., Fan, X., Xu, Y., Liu, F., Peng, C., Ren, W., & Wang, L. (2017). Esophageal foreign body ingestion in adults on weekdays and holidays: A retrospective study of 1,058 patients. Medicine, 96(43), e8409. https://doi.org/10.1097/MD.0000000000008409

Chawla, A., Bosco, J., Subramanian, M., Chokkapan, K., Shenoy, J., & Lim, T. C. (2015). Imaging findings of swallowed dentures: A case series. Emergency Radiology, 22(6), 717–721. https://doi.org/10.1007/s10140-015-1334-5

Chang, M.-Y., Chang, M.-L., & Wu, C.-T. (2006). Esophageal perforation caused by fish vertebra ingestion in a seven-month-old infant demanded surgical intervention: A case report. World Journal of Gastroenterology, 12(44), 7213–7215. https://doi.org/10.3748/wjg.v12.i44.7213

Swaminathan, N., Aboeed, A., Al-Obaidi, M., & Aggarwal, A. (2019). Pneumomediastinum in a heavy weightlifter. European Journal of Case Reports in Internal Medicine, 6(5), 001085. https://doi.org/10.12890/2019_001085

Towbin AJ. The CT appearance of intraoral chewing gum. Pediatr Radiol. 2008 Dec;38(12):1350-2. doi: 10.1007/s00247-008-0980-0. Epub 2008 Aug 19. PMID: 18712374.

Alexandre PL, Pinto JV, Costa L, Marques P, Moura CP. Rigid Esophagoscopy for Foreign Body Extraction: Results and Complications in the Endoscopic Era. Cureus. 2024 Jan 27;16(1):e53040. doi: 10.7759/cureus.53040. PMID: 38410347; PMCID: PMC10895686.

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The journal of "Otorhinolaryngology and Facial Plastic Surgery" is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Print ISSN: 2538-5224; Online ISSN: 2538-5216

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