21 September 2026
: Case report 
EVT-Inspired Simplified Negative-Pressure Nasoesophageal Drainage for Cervical Abscess Secondary to Esophageal Perforation
Management of emergency care
Lisha Yi AEF 1*, Linquan Zheng BDE 2, Zelong Huang BC 2, Yuling Yang DE 3DOI: 10.12659/AJCR.953266
Am J Case Rep 2026; 27:e953266
Table 1 Chronological clinical course of the patient.
| Hospital day | Clinical events | Laboratory findings | Imaging | Interventions |
|---|---|---|---|---|
| Day 1 | Severe neck pain, dysphagia, fever(38.9 °C) | WBC: 22.78 × 10/L; CRP: 113.38 mg/L | CT neck/chest: Esophageal perforation with peri-esophageal emphysema | Extract the fish bone under endoscopy; IV antibiotics (cefotaxime + ornidazole), IV PPI (omeprazole 40 mg twice daily), NPO |
| Day 2 | Persistent symptoms; patient declined standard NGT | – | – | Continued conservative management |
| Day 3 | Throat pain and chest tightness worsened | WBC: 11.19 × 10/L; CRP: 88.3 mg/L | – | Decision to proceed with EVT-Inspired SNPND |
| Day 3 (post-procedure) | Modified 16-Fr NGT inserted blindly to 30 cm from nares; connected to disposable negative pressure drainage ball | – | Follow-up CT: Abscess expansion (43 × 20 × 48 mm)Tube tip: Mid-esophagus, T8 level | SNPND initiated; ball half-compressed q6h |
| Day 4–10 | Gradual resolution of neck pain; cumulative drainage approximately 30 mL (purulent) | – | – | Continued IV antibiotics, PPI and parenteral nutrition |
| Day 11 | Asymptomatic; patient requests early oral feeding | WBC: 5.63 × 10/L; CRP: 7.32 mg/L | Subsequent chest CT: Regression of neck abscess; esophageal wall edema | EGD: Solitary ulcer 18–20 cm from incisors with a purplish skin tag; 1 clip closure. |
| Day 12 | No dysphagia or pain | – | – | Liquid diet initiated |
| Day 13 | Tolerating liquids; no fever | – | – | Advanced to soft diet |
| Day 18 | Discharged; asymptomatic | – | – | Oral antibiotics completed; outpatient follow-up arranged |
| Month 1 | Telephone follow-up: remains asymptomatic, normal oral intake | – | – | – |
| Month 8 | Extended follow-up: Continues asymptomatic, no dysphagia/fever/neck pain | – | – | Ongoing clinical surveillance; patient declined elective endoscopy |
| Abbreviations: WBC, white blood cell count; CRP, C-reactive protein (mg/L); CT, computed tomography; NPO, nil per os; IV, intravenous; PPI, proton pump inhibitor; NGT, nasogastric tube; SNPND, simplified negative-pressure nasoesophageal drainage; EGD, esophagogastroduodenoscopy. Clip: Vedkang (Jiangsu Vedkang Medical Science and Technology Co, Ltd, China). | ||||