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Volume 16
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10.3390/life16040639
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Background:
Case Report

Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics

by
Bogdan Mihnea Ciuntu
1,
Edwina-Elena Viciriuc
2,*,
Andreea Ludusanu
3,*,
Adelina Tanevski
1,
Mihaela Corlade-Andrei
4,
Sorin Nicolae Peiu
5,
Raluca Alina Dragomir
2,
Dan Vintila
1,
Cristinel Ionel Stan
3 and
Gheorghe Balan
6
1
Department of General Surgery, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
2
Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
3
Department of Morpho-Functional Sciences I—Anatomy, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
4
Department of Emergency Medicine, Surgery II, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
5
Department of Vascular Surgery, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
6
Department of Gastroenterology, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania
*
Authors to whom correspondence should be addressed.
Life 2026, 16(4), 639; https://doi.org/10.3390/life16040639
Submission received: 9 February 2026 / Revised: 27 March 2026 / Accepted: 8 April 2026 / Published: 10 April 2026
(This article belongs to the Section Medical Research)
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Abstract

Background: Upper esophageal perforations are life-threatening conditions associated with a high risk of mediastinitis, sepsis, and multiorgan failure. Standard management often requires extensive surgical intervention, which carries substantial morbidity. Methods: We report the case of a 56-year-old male with an iatrogenic cervical esophageal perforation complicated by cervicomediastinal abscess formation. Due to anatomical constraints preventing standard endoluminal approaches, a hybrid organ-preserving strategy was employed, consisting of surgical drainage combined with an externally adapted vacuum-assisted closure (VAC) system applied adjacent to the esophageal defect. Results: The patient demonstrated progressive clinical improvement without the need for esophageal diversion or major reconstructive surgery. Inflammatory markers were monitored serially and showed a downward trend, serving as adjunctive indicators of treatment response. The esophageal defect healed successfully, was confirmed radiologically, and no treatment-related complications were observed. Conclusions: This case suggests that externally adapted VAC therapy may represent a potential organ-preserving option in selected patients with complex cervical esophageal perforations when conventional techniques are not feasible. Further studies are required to validate this approach.
Keywords: cervicomediastinitis; cervico-mediastinal abscess; cervical esophagus; cervical esophageal perforation; EVAC; deep neck infection; tracheostomy cervicomediastinitis; cervico-mediastinal abscess; cervical esophagus; cervical esophageal perforation; EVAC; deep neck infection; tracheostomy

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MDPI and ACS Style

Ciuntu, B.M.; Viciriuc, E.-E.; Ludusanu, A.; Tanevski, A.; Corlade-Andrei, M.; Peiu, S.N.; Dragomir, R.A.; Vintila, D.; Stan, C.I.; Balan, G. Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics. Life 2026, 16, 639. https://doi.org/10.3390/life16040639

AMA Style

Ciuntu BM, Viciriuc E-E, Ludusanu A, Tanevski A, Corlade-Andrei M, Peiu SN, Dragomir RA, Vintila D, Stan CI, Balan G. Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics. Life. 2026; 16(4):639. https://doi.org/10.3390/life16040639

Chicago/Turabian Style

Ciuntu, Bogdan Mihnea, Edwina-Elena Viciriuc, Andreea Ludusanu, Adelina Tanevski, Mihaela Corlade-Andrei, Sorin Nicolae Peiu, Raluca Alina Dragomir, Dan Vintila, Cristinel Ionel Stan, and Gheorghe Balan. 2026. "Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics" Life 16, no. 4: 639. https://doi.org/10.3390/life16040639

APA Style

Ciuntu, B. M., Viciriuc, E.-E., Ludusanu, A., Tanevski, A., Corlade-Andrei, M., Peiu, S. N., Dragomir, R. A., Vintila, D., Stan, C. I., & Balan, G. (2026). Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics. Life, 16(4), 639. https://doi.org/10.3390/life16040639

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