Hypopharyngeal perforation caused by blunt trauma during consensual fellatio: an expectant management approach

Abstract

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.

Digestive Health in Sexual and Gender Minority Populations

“…While there are rare reports of significant oropharyngeal and anorectal trauma with penetration (48,49), the practice of both oral and anal sex are overwhelmingly safe. Given differences between the vaginal mucosa (which is primed during sexual arousal to facilitate insertion) (50) and anorectal mucosa, adequate lubrication is necessary to reduce the possibility of trauma.…”

Penetrating hypopharyngeal foreign body impalement of the thyroid gland: A case report of rare complication of ingested fish bone

“…Which, sharp objects may get lodged in the aerodigestive tract and subsequently cause a perforation. Although perforation of the hypopharynx is rare, early recognition and treatment is crucial to decrease the associated morbidity [ 1 , 2 ].…”