{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:20Z","timestamp":1756425860134,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,4,28]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>A 62-year-old man was referred to the emergency department with retrosternal chest pain for 4\u2009days. Coronary angiogram and ECG showed no occlusion of coronary vessels. Contrast-enhanced CT of thorax showed b\/l pleural effusion, pneumomediastinum, right hydropneumothorax, with the underlying collapse of lungs and intercostal drainage tube in situ. Intercostal tube showed purulent discharge. Repeat oral contrast did not show any leakage through the upper gastrointestinal tract, and the patient is admitted to the intensive care unit following endotracheal intubation. However, an upper gastrointestinal endoscopy, performed at the bedside in the intensive care unit unexpectedly revealed a foreign body (piece of coconut shell) impacted at the lower oesophagus. The foreign body was removed successfully using oesophagoscopy, and the patient made a full recovery following multidisciplinary teamwork between critical care and surgeons.<\/jats:p>","DOI":"10.1136\/bcr-2020-236055","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T11:55:47Z","timestamp":1621857347000},"page":"e236055","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual case of retrosternal chest pain: a twist in the tale"],"prefix":"10.1136","volume":"14","author":[{"given":"Irene Mary","family":"Ike","sequence":"first","affiliation":[{"name":"Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8507-5698","authenticated-orcid":false,"given":"Sanjan","family":"Asanaru Kunju","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Priya","family":"Pattath Sankaran","sequence":"additional","affiliation":[{"name":"Department of Radiodiagnosis, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neenu","family":"Prasad","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"2025082804261945000_14.5.e236055.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2003.08.037"},{"key":"2025082804261945000_14.5.e236055.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jviscsurg.2010.08.003"},{"key":"2025082804261945000_14.5.e236055.3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/8520767","article-title":"Endoscopic management of foreign bodies in the gastrointestinal tract: a review of the literature","volume":"2016","author":"Bekkerman","year":"2016","journal-title":"Gastroenterol Res Pract"},{"key":"2025082804261945000_14.5.e236055.4","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2009.00959.x"},{"key":"2025082804261945000_14.5.e236055.5","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s00268-008-9857-5","article-title":"How to treat esophageal perforations when determinants and predictors of mortality are considered","volume":"33","author":"Udelnow","year":"2009","journal-title":"World J Surg"},{"key":"2025082804261945000_14.5.e236055.6","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4356"},{"key":"2025082804261945000_14.5.e236055.7","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/j.jchir.2009.08.012","article-title":"Aortic rupture due to a swallowed medical needle","volume":"146","author":"Champault","year":"2009","journal-title":"Journal de chirurgie"},{"key":"2025082804261945000_14.5.e236055.8","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-100456"},{"key":"2025082804261945000_14.5.e236055.9","article-title":"Endoscopic evaluation of penetrating esophageal injuries","volume":"88","author":"Horwitz","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025082804261945000_14.5.e236055.10","article-title":"Proposed management protocol for ingested esophageal foreign body and aortoesophageal fistula: a single-center experience","volume":"8","author":"Wei","year":"2015","journal-title":"Int J Clin Exp Med"},{"key":"2025082804261945000_14.5.e236055.11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.ijscr.2015.10.033","article-title":"Double esophageal perforation by ingested foreign body: endoscopic and surgical approach. 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