Citation

Schrom T, Amm S. Laryngorhinootologie 2009; 88(4): 253-256.

Vernacular Title

Ungewohnlicher Osophagusfremdkorper im Rahmen eines Autoaggressionssyndroms.

Affiliation

Klinik fur Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen Helios Klinikum Bad Saarow.

Copyright

(Copyright © 2009, Georg Thieme Verlag)

DOI

10.1055/s-0028-1100381

PMID

19347783

Abstract

Foreign bodies in the esophagus represent a frequent emergency situation in ENT medicine. Usually the cases involve lumps of meat, bones, shards of glass, bottle tops, batteries or dentures. We would like to report about an unusual foreign body found in the oesophagus. PATIENT: A 45-year-old patient presented himself in our interdisciplinary casualty department where he claimed to have swallowed a butter-knife that morning as a bet. The ENT examination showed no abnormal findings. The thorax X-Ray revealed a 14 cm-long foreign body in projection to the oesophagus, which matched the knife. Following consultation with the thorax surgeon, a rigid esophagoscopy was conducted under endotracheal intubation and the knife was easily removed using tongs. Archive searches conducted in the meantime showed that foreign bodies had been removed from the patient on numerous occasions by fellow surgeons either laparoscopically or via open surgery. As a result, the patient was transferred to the psychiatric ward with unimpeded swallowing reflex with a suspected self-harming syndrome. DISCUSSION: As an ENT emergency, a foreign body in the esophagus generally requires intervention because of the risk of complications such as perforation or pressure-induced necrosis of the esophagus wall with resulting mediastinitis. Suitable instruments are the flexible esophagoscope, the rigid esophagoscope under anaesthesia or transcervical/transthoracic removal. The choice of procedure crucially depends on the type and localisation of the foreign body in the oesophagus. Particularly in cases of unusual foreign objects or repeated foreign object ingestion, it should be considered whether a psychological illness could be the cause and whether the introduction of appropriate therapy could be expedient.

Language: de