Esophageal foreign body impaction is mostly managed with endoscopic retrieval. However, in cases of large or irregularly shaped foreign bodies, or in cases of long standing impaction, this technique carries a high risk of perforation and a surgical approach is often mandatory.The authors report the case of a 55 year old woman, with a past history of mental retardation, presenting with dysphagia for solid food and regurgitation beginning one month earlier. After failed extraction by flexible esophagoscopy,the denture was removed by esophagotomy through a postero-lateral thoracotomy. In the postoperative period the patient developed a leakage of the suture line with resultant esophago-pleural fistula which was managed with double esophageal exclusion. She was discharged on the 40th postoperative day on semi-solid diet and is presently (eight months after the first surgery) symptom free.