Unusual Case of a Prolonged Esophageal Foreign Body With Tracheoesophageal Fistula in a Child

3 Sep 2020 02:10 02:10
Bomet
Kulwinder S. Dua  Host
Matthew Read  Host
Michael Mwachiro Host
Russell E White Host

Case Overview

An unusual case of a 6-year-old female involving a foreign body lodged in the esophagus for an extended period of time. The case required a multidisciplinary approach between surgeons and endoscopists to provide appropriate initial care for the patient, and for the complications which arose.

Patient Profile & Clinical Presentation

  • Patient: 6-year-old female

  • Presenting Symptom: Persistent cough of at least three months duration.

  • Chest Radiograph: Revealed the presence of a foreign body in the oesophagus at the level of the tracheal carina.

  • History: Neither the patient nor her mother recalled the incident of ingesting the foreign body.

  • Dietary Tolerance: The child was able to tolerate a normal diet without difficulty.

  • General Condition: She did not appear to be in any significant distress, but did have a persistent cough.

Upper GI Endoscopy

  • Foreign Body: Metallic foreign body firmly wedged in the mid-esophagus.

  • Complication: A trachea-esophageal fistula appeared to be present on the anterior surface of the esophagus.

Multidisciplinary Approach

The case required a multidisciplinary approach between surgeons and endoscopists to provide appropriate initial care for the patient and to manage the complications which arose.

Discussion Points

  1. What would you do with this patient?

  2. What would be your therapeutic strategy?

  3. How would you proceed surgically?