Esophageal Foreign Bodies: An Experience with Rigid Esophagoscope

Abstract

Background: Foreign body impaction in the upper aero-digestive tract is a common presenting problem to the ENT surgeons. We studied the results of rigid esophagoscopy for esophageal foreign bodies. Methodology: This descriptive study was carried out in Saidu Teaching Hospital, Swat, from January 2006 to June 2009. Patients with history of foreign body impaction were included. Esophagoscopies were performed by ENT consultant with rigid esophagoscope. Age, sex, type of foreign body, site of impaction and underlying pathology were recorded. Dilatation of the strictures and webs was carried out. Biopsies were taken where indicated. Patients were kept in ward for 24 hours for observation after procedure. Results: Among 212 patients, 132(63%) were males and 80(38%) females. Of these 128(60.26%) were 50, and 39(18.39%) in middle age groups. Coins 118(55.6%) were the most common foreign bodies followed by meat bolos 44(20.75%), dentures 15(7.07%), fish bone 15(7.07%), chicken bone 10(4.7%), battery cell, peach seeds artificial jewelry 2 each (0.94%), marble ball and bone chip 1 each (0.47%). Out of 212 patient 185 had no pathology while 27(12.73%) had underlying pathology; webs 9(4.74%), malignant neoplasm 7(3.30%), benign stricture 8(3.7%), achalasia, diverticulum and neopharynx 1 each (0.47%). In 202(95.28%) foreign body was removed, while in 10(4.07%) these passed spontaneously. Webs and benign strictures were successfully dilated. Biopsies were taken in 15(7%). No mortality and mild odynophagia was encountered. Conclusion: Rigid endoscopy is still a gold standard diagnostic and therapeutic tool for upper aerodigestive tract pathologies. A second look after foreign body removal is essential to exclude any underlying pathology.