Unusual foreign body in the esophagus: A challenge for the anesthesiologist

Abstract

A foreign body in the esophagus is usually removed by endoscopy. An elder man entered the emergency room dyspneic and dysphagic. A chest X-ray showed that he had a table fork stuck in the upper esophagus. An endoscopist tried to remove it without success. After bilateral block of the superior laryngeal nerve, transtracheal injection, topical anesthesia of the mouth, and sedation, an awake laryngoscopy was carried out. Pushing the laryngoscope into the opening of the esophagus the fork was seen and extracted by the anesthesiologist. This case focuses on the role of the anesthesiologist in the removal of esophageal foreign bodies.

Endoscopic Techniques and Management of Foreign Body Ingestion and Food Bolus Impaction in the Upper Gastrointestinal Tract: A Retrospective Analysis of 139 Cases

“…Notably, sometimes the anesthesiologist may play a role in the removal of esophageal foreign bodies through a laryngoscope. 44 Our patients with suspected foreign body ingestion had anteroposterior and lateral radiographs of the neck, chest, or abdomen to help determine the presence, type, and location of a foreign body. A plain radiograph should be obtained before endoscopy in the case of radiopaque objects to determine the location of the foreign body, but a barium or contrast study should never be performed in such cases.…”

Unusual Esophageal Foreign Body: A Table Fork

“…Only three cases of a fork in the esophagus were found in the literature [7–9]. Two of these patients, suffering from eating disorders, were trying to trigger vomiting using the handle of the fork to irritate their pharynx when the fork accidentally slipped into the esophagus [7, 8].…”

“…Two of these patients, suffering from eating disorders, were trying to trigger vomiting using the handle of the fork to irritate their pharynx when the fork accidentally slipped into the esophagus [7, 8]. The circumstances of the most recent case are the same as those of the patient observed by us: an attempt to stop hiccups [9]. In all cases, the fork presented with the prongs pointing up and was removed under direct vision.…”

Lesiones múltiples por tenedor de mesa en el contexto de un homicidio

“…En este sentido se describen lesiones por tenedor en una autoenucleación ocular 3 o como cuerpo extraño extraído del tubo digestivo [4][5][6][7][8] . Por este motivo, consideramos que el conocimiento de este patrón lesivo inusual puede ser extremadamente útil al médico forense que se enfrenta a ellas por primera vez.…”