14 year old girl was admitted to the hospital with complaints of dysphagia, odynophagia, dyspnea and swelling of the left cervical region after swallowing a fish bone one week prior to this admission. The fish bone was removed from the cervical esophagus with esophageal forceps through the esophagoscope. A perforation was demonstrated on the left lateral wall of the cervical esophagus, from which about 5cc of thick yellowish pus was drained. Patient’s general condition was deteriorated gradually with severe dyspnea. Chest x-ray revealed cardiomegaly, multiple irregular densities in both upper lobes and widening of mediastinum. Coller’s mediastinotomy was performed on the third hospital day and the patient expired on the second day of the operation. Autopsy revealed mediastinal abscess around both esophagus and trachea, hydropyothorax (400cc), acute pericarditis (60cc) and atelectasis of both lungs.