Inhalation and ingestion can potentially cause pneumonia, mediastinitis, peritonitis, or sepsis, which may be life threatening (2).

Last, but not least, due to elevated inflammatory markers we have reflected on infectious esophagitis, but our patient did not presented any inflammatory symptoms until the esophagus perforation occurred and lead to mediastinitis.

The high mortality rate in RP abscesses is due to complications, such as airway obstruction, mediastinitis, aspiration pneumonia, epidural abscess, jugular venous thrombosis, necrotizing fasciitis, sepsis, and carotid artery erosion (9).

If the patient suffers from severe shortness of breath, 100% oxygen supplementation should be provided, and antibiotherapy should be administered if mediastinitis develops (3,7).

Most common sternal wound complications were superficial infection and sterile dehiscence, no patient had mediastinitis. Perioperative myocardial infarction, chest infection, renal dysfunction and neurologic problems are slightly less in the IMA (+- vein) group.

A complication rate of 1-5% may occur during the removal of oesophageal foreign bodies or while awaiting surgical intervention.1 A foreign body itself, if its remaining in the oesophagus for along time, or its causing problems during oesophagoscopy, may lead to such major life-threatening complications as oesophageal perforation, secondary mediastinitis, sepsis, retropharyngeal abscess, oesophageal airway fistulas, oesophageal foreign body exudates, pseudo-oesophageal diverticula, and aorto-oesophageal fistula.12

Usual complications include mediastinitis, asfixia, septicemia, and empyema (5).

Expeditious treatment of FB is key to minimizing secondary injuries, as there is evidence that increased time of impaction of FBs is related to increased risk of complications, including esophageal perforation, extraluminal migration, mediastinitis, abscess, and vascular injury.

Extraluminal migration of an FB may damage nearby structures such as the trachea, aorta, or lung or lead to infection, manifesting as either a local abscess or necrotizing mediastinitis. (2,3)

Complications include oesophageal perforation, mediastinitis, trachea-oesophageal fistula and oesophageal stenosis (1,2).

Fibrosing mediastinitis has similar radiologic features with the features of lgG4-RD elsewhere in the body.