• Mose Chun, Daesup Lee, Mun Ki Min, Ji Ho Ryu, and Min Jee Lee.
• Department of Emergency Medicine, Pusan National University Yangsan Hospital, Yangsan, South Korea.
• Medicine (Baltimore). 2023 Dec 1; 102 (48): e36364e36364.

RationaleAcute phlegmonous esophagitis (APE) is bacterial infection of the submucosal and muscularis layers of the esophagus. APE is a rare but life-threatening disease, and few studies have reported it.Patient ConcernsA 63-year-old Korean woman was admitted to the emergency department complaining of chest pain. Contrast-enhanced computed tomography revealed diffuse esophageal wall thickening with low attenuation and paraesophageal fluid collection in the mediastinum. Esophagomyotomy, mediastinal abscess drainage with a right thoracotomy, and left 3-port video-assisted thoracoscopy were performed in the operating room.DiagnosesContrast-enhanced computed tomography revealed diffuse esophageal wall thickening with low attenuation and paraesophageal fluid collection in the mediastinum.InterventionsEsophagomyotomy, mediastinal abscess drainage with a right thoracotomy, and left 3-port video-assisted thoracoscopy were performed in the operating room.OutcomesThe patient followed up through an outpatient visit 4 days later discharged. The patient progress was good, and she decided to visit the patient if she had pain afterwards.LessonsAs APE is rare but deadly, strategies to identify APE in patients with chest pain or dysphagia are needed in emergency department.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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