Managing an impacted sharp oesophageal foreign body in an infant: a vital approach using a rigid oesophagoscopy
摘要
Oesophageal foreign bodies (EFBs) are a common presentation among paediatric patients especially between six months and three years old. However, managing a sharp EFB can be tricky especially in an infant. Various methods have been developed over the years to tackle this conundrum. Depending on the sites, types and available expertise; these are usually managed with either rigid or flexible oesophagoscopy. This case report emphasizes a vital approach using rigid oesophagoscopy as an adjunct to flexible oesophagscopy.
Case presentationWe demonstrated a clinical scenario involving an impacted sharp metal pin at the mid-oesophagus in a six-month-old infant. After a futile attempt in retrieving the EFB using the neonate oesophageal-gastro-duodenoscope (OGDS) by the paediatric surgical team, the otorhinolaryngology team performed a rigid oesophagoscopy using a rigid Robert-Jesberg oesophagoscope. The metal pin was successfully grasped using a bigger, more robust optical forceps and was brought into the cylinder of the rigid oesophagoscope. The EFB was extracted out safely by withdrawing the scope-forceps unit as whole, thus en mass with the rigid thus, preventing injury to the oesophageal mucosa.
ConclusionRigid oesophagocopy is a valuable tool for removing oesophageal foreign bodies in children especially for sharp objects. It is larger in diameter, allowing for bigger studier retrieval instruments to pass thru the scope. In addition to that, the grasped foreign bodies can be withdrawn into the more capacious lumen, diminishing the propensity of the foreign body to lacerate the mucosa during retrieval.