Endoscopic examinations of swallowing passages may be ass ociated withsimple or severe complications, the latter including perforation injury, and may results in health or even life-threatening conditions. The perforation of iatrogenic origin in the region of hypopharynx and esophagus belong to rare, but very serious conditions. The data in literature presents incidence of such events from 1 to 1.7 cases per 1000 endoscopic examinations. Lethality is in the range of 0.5 to three cases per 10,000 cases (1, 2, 3). The described case report shows some moments, which followed to late recognition of gastroscopy complication. The late diagnosis resulted in the development of inflammation, which endangered the life of the patients and had to be solved by surgery. The patient, who was examined by gastroscopy at surgery outpatient department in a district hospital of the Hradec Králové region, was then hospitalized for intensifying complaints at the otolaryngologicalward of the same hospital.The circumstances of examination as well as immediate difficulties of the patient were not sufficiently appreciated as warning symptoms of possible complications. The subsequent deterioration of health state of the patient was ten suspected to indicate possible perforation injury. The condition of the patient required a rapid surgical intervention with intensive postoperation care at the hospital of higher type. The analysis of the case might contribute to prevention of such cases to occur in the future.

        Key words: flexible gastroscopy, perforation of esophagus, perforation of hypopharynx, mediastinitis, parapharyngeal abscess.