Cervical esophageal stenosis: an uncommon complication of thyroidectomy.

Abstract

Introduction and importance: Cervical esophageal stenosis is a rare but serious complication following thyroidectomy. It presents with dysphagia and odynophagia, which can mimic common postoperative symptoms, leading to delayed diagnosis. Early recognition is crucial for timely intervention and improving patient outcomes.

Case presentation: A 64-year-old female with papillary thyroid carcinoma (PTC) underwent total thyroidectomy. Intraoperatively, an iatrogenic esophageal injury was sutured. Postoperatively, she developed dysphagia, dyspnea, and neck swelling. Imaging revealed cervical esophageal stenosis, and despite initial management with a nasogastric tube and gastrostomy tube, her dysphagia persisted. A corrective partial cervical esophagectomy was performed, and the patient recovered uneventfully, resuming oral intake after 6 days.

Clinical discussion: Cervical esophageal stenosis can result from surgical trauma or inflammation during thyroidectomy, particularly in patients with PTC. Early imaging and clinical assessment are key for diagnosis. Severe stenosis may require surgical correction, such as esophagectomy, when endoscopic dilation is not sufficient.

Conclusion: Cervical esophageal stenosis should be considered in patients with post-thyroidectomy dysphagia. Prompt diagnosis and intervention, including surgery when necessary, can prevent long-term complications and improve quality of life.