PT  - JOURNAL ARTICLE
AU  - Noon, Edward
AU  - Stapleton, Emma
TI  - Hypopharyngeal perforation caused by blunt trauma during consensual fellatio: an expectant management approach
AID  - 10.1136/bcr-2021-242846
DP  - 2021 Aug 01
TA  - BMJ Case Reports
PG  - e242846
VI  - 14
IP  - 8
4099  - http://casereports.bmj.com/content/14/8/e242846.short
4100  - http://casereports.bmj.com/content/14/8/e242846.full
SO  - BMJ Case Reports2021 Aug 01; 14
AB  - Perforation of the pharynx is a rare occurrence but has the potential to cause mediastinitis and has an attendant mortality risk. Though numerous mechanisms have been described, we report a unique case of a young woman who presented with a sore throat, odynophagia and subcutaneous emphysema, a short time after performing fellatio. A contrast swallow confirmed hypopharyngeal perforation. She was managed expectantly with nasogastric feeding and empirical antibiotics. The perforation took 4 weeks to heal, but there were no residual swallowing problems at 3-month follow-up. We will explore the incidence and causes of pharyngeal perforation and discuss the options for and risks of surgical repair. This case highlights that non-surgical management of such injuries can be both safe and feasible, and reinforces the importance of ensuring confidentiality and the need for vigilance regarding potential non-consensual injury.