Perforation of the Esophageal Wall due to Large-Sized Foreign Body Entering the Esophagus

Foreign bodies entering the esophagus may result from rapid food intake, reduced sensitivity of the mucous membrane of the oral cavity in some neurological diseases, under mental illness, in individuals of certain professions. In 3-4% of cases, this results in perforations of the esophagus due to either presence of acute traumatic margins of the foreign body, or by a long-term presentation of a foreign body in the esophagus and, consequently, the development of a pressure injury. Considering the above, timely and complete diagnosis and adequate surgical treatment in the first hours after diagnosed esophageal perforation by a foreign body is a must.

The patient was admitted to the department of thoracic surgery with complaints of a foreign body in the throat, hypersalivation, subcutaneous emphysema of the neck. He felt sick 2 hours ago, when during sleep he had swallowed a denture. The patient was examined and diagnosed with a foreign body of the upper third of the esophagus with perforation. He was urgently administered: 1. fibroesophagoscopy + reduction of the foreign body in the stomach; 2. Left-sided colotomy, suturing of the upper thoracic esophagus, drainage of the prevertebral space; 3. Upper median laparotomy, gastrotomy, removal of a foreign body, gastrostomy according to Kader’s method. The patient was discharged with a gastrostomy from the hospital in a satisfactory condition, he was recommended follow-up observation by a local surgeon in the outpatient clinic. The gastrostomy was closed conservatively 3 weeks after the discharge. In 2 weeks after the closure of gastrostomy, the patient returned to a full life and working activity.