From Ingestion to Septic Shock: A Case Report on Esophageal Perforation and Mediastinitis Following Foreign Body Ingestion

Acute mediastinitis is a rare but life-threatening condition, most commonly secondary to esophageal perforation. Foreign body ingestion in adults is an unusual etiology, with limited data from Morocco, where only a few cases have been reported. We report a case of mediastinitis complicating esophageal perforation following accidental foreign body ingestion in a Moroccan patient, highlighting diagnostic challenges and management in a resource-limited setting. We report the case of a 38-year-old patient admitted with septic shock, complicated by dysphagia and epigastric pain, five days after accidental foreign body ingestion. A cervicothoracic CT scan revealed esophageal perforation complicated by mediastinitis and inhalation pneumonia. Emergency surgical management consisted of a Kocher cervicotomy with mediastinal drainage, combined with early broad-spectrum antibiotic therapy, which led to a favorable postoperative outcome. This case from Morocco underscores the importance of early clinical suspicion, prompt CT imaging, and aggressive medico-surgical management in improving outcomes, even in delayed presentations. It contributes to the growing body of regional literature on foreign body-induced mediastinitis in North Africa.