Pleural empyema: An unusual presentation of esophageal perforation

A 67-year-old patient presented with pleural empyema as the sole manifestat ion of thoracic esophageal perforation, 2 weeks after accidental fish bone ingestion. Nonspecific chest pain and general deterioration, unusual presen ting symptoms in themselves, accounted for the extreme delay in the diagnos is. The empyema was treated surgically, and the esophageal perforation cons ervatively. Despite the poor prognostic factors, the patient recovered comp letely after 50 days in hospital.