Abstract

Figure 1: (A) Chest radiography revealed a 1.5-cm radio-opaque density at the level of the T4-5 vertebrae. (B and C) Chest computed tomography demonstrated bilateral neck subcutaneous emphysema and pneumomediastinum with a tubular structure, 15 cm in length, in the cervical and upper thoracic oesophagus. (D) The upper posterior mediastinal pleura were opened, and a ballpoint pen was found between oesophagus and vertebral body.

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