Retained foreign body located at the ostium of an esophageal diverticulum: A case report

Abstract

Introduction: Esophageal foreign body impaction is a problem commonly seen in pediatric emergency departments, often requiring emergency surgical removal. However, no cases of foreign body impaction at the ostium of an esophageal diverticulum have been reported in the literature. Case presentation: A 1-year-old boy was admitted to our hospital due to a 5-month history of persisting cough. He was initially diagnosed with an upper respiratory tract infection, which did not respond to medical treatment for 4 months. An X-ray was done at a community hospital, revealing a round-shaped metallic foreign body in the upper esophagus. His parents were unable to recall any unusual history of swallowing foreign objects. Physical examination revealed coarse breath sounds in both lungs, with no other abnormal findings. The patient underwent an initial endoscopy were we found the foreign body, but it was embedded in the esophageal mucosa and could not be retrieved. We subsequently obtained a computerized scan to better understand the location of the foreign body. A second endoscopy was done 48 hours later, during which we were able to remove the foreign body, which was a coin. Once the coin was retrieved, we realized that it had been lodged at the entrance of an esophageal diverticulum. We confirmed the diagnosis 5 days later with a contrast esophagram. The patient recovered successfully without complications. At 6 months of follow up, the patient remains asymptomatic. Conclusion: Persistent cough may be a symptom of esophageal foreign bodies. Pediatric surgeons should be aware that foreign bodies can be lodged at the entrance or within an esophageal diverticulum.

Keywords

• Chronic esophageal foreign body
• Esophageal diverticulum
• Case report