A 18 year-old boy was admitted to Chonnam University Hospital with chief complaints of dysphagia, odynophagia and swelling of the left cervical region. A day before entry he had experienced swallowing of a seed of peech by mistake. On that day he had visited to a local clinic and treated with bouginge and swelling of the left cervical and enterior chest region had developed. Physical examination revealed semicomatous state which appeared to be acutely ill. There was crepitant rales on both lateral neck and anterior chest region. Moist rales could by heard both lung field. X-ray study of the chest P-A and right lateral view revealed marked windening of the right supracardiac shadow with thickened minor interlobar fissure and localized emphysema in the retrosternal region. Esophagoscopy was performed and removed seed of peech with esophageal forceps. Second hospital day Stamm's gastrostomy with mediastinotomy were performed and treated with massive antibiotics and fluids administered intravenously.