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Journal of the Philippine Medical Association ; : 59-67, 2022.
Article in English | WPRIM | ID: wpr-962590

ABSTRACT

OBJECTIVES@#This paper aims to present a rare case of a 34-year old male who had esophageal food bolus impaction on top of stricture formation secondary to a retained 12-year esophageal foreign body (denture). It also aims to state the significance of proper and comprehensive history taking, physical examination and corresponding ancillary procedures to arrive at its diagnosis and to highlight the importance of a multidisciplinary team in the prevention and management of complicated foreign body (FB) impaction.@*DESIGN@#Case Report@*SETTING@#Government Tertiary Hospital@*PATIENT@#One@*RESULTS@#A 34-year old male presented with one day history of dysphagia after ingesting a chunk of pork. He had no other symptoms and was not in any respiratory distress. Physical examination was unremarkable except for missing dentition (teeth #8, #9 by universal notation system). Radiographic imaging, esophagogram and contrast-enhanced chest CT scan revealed partial proximal esophageal obstruction probably secondary to retained foreign body at the level ofT5 vertebra. Rigid esophagoscopy with removal of foreign body (food bolus) was done. However, there was difficulty insinuating the scope beyond this level. Further investigation and the use of multispecialty collaboration eventually led to the retrieval of a 12-year denture covered by a bimucosal flap with surrounding stricture formation.@*CONCLUSION@#Foreign body impaction, while more commonly found in the pediatric population, may also occur in adults especially those with edentulism, psychiatric disorders, alcoholism and preexistent esophageal pathologies. In rare cases, patients may be asymptomatic resulting to a delay in its diagnosis. In addition to a well-taken history and physical examination, direct visualization and computed tomography are vital for evaluation. A multidisciplinary approach is critical in its management especially when anticipating difficult extraction and considering FB impaction complications.

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