{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T13:31:02Z","timestamp":1782826262415,"version":"3.54.5"},"reference-count":35,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,20]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Perforation of the pharynx is a rare occurrence but has the potential to cause mediastinitis and has an attendant mortality risk. Though numerous mechanisms have been described, we report a unique case of a young woman who presented with a sore throat, odynophagia and subcutaneous emphysema, a short time after performing fellatio. A contrast swallow confirmed hypopharyngeal perforation. She was managed expectantly with nasogastric feeding and empirical antibiotics. The perforation took 4 weeks to heal, but there were no residual swallowing problems at 3-month follow-up. We will explore the incidence and causes of pharyngeal perforation and discuss the options for and risks of surgical repair. This case highlights that non-surgical management of such injuries can be both safe and feasible, and reinforces the importance of ensuring confidentiality and the need for vigilance regarding potential non-consensual injury.<\/jats:p>","DOI":"10.1136\/bcr-2021-242846","type":"journal-article","created":{"date-parts":[[2021,8,10]],"date-time":"2021-08-10T13:21:24Z","timestamp":1628601684000},"page":"e242846","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Hypopharyngeal perforation caused by blunt trauma during consensual fellatio: an expectant management approach"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3043-6174","authenticated-orcid":false,"given":"Edward","family":"Noon","sequence":"first","affiliation":[{"name":"Otolaryngology Department, Manchester Royal Infirmary, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Otolaryngology Department, Manchester Royal Infirmary, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,10]]},"reference":[{"key":"2025082707155295000_14.8.e242846.1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/014556130308200111","article-title":"Is same-day discharge suitable following rigid esophagoscopy? 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