Abstract

Onotai L.O. and Etawo U.S

Background: Foreign body (FB) ingestion and impaction in the esophagus constitutes an important cause of morbidity and mortality worldwide. Most of the impacted foreign bodies in the esophagus require endoscopic removal with rigid esophagoscopy. Objective: This study seeks to highlight the challenges in the management of esophageal FB using rigid esophagoscopy. It will also evaluate the outcome of management. Patients and Method: This was a retrospective study of 70 patients with confirmed esophageal foreign bodies that were managed in the Ear, Nose and Throat (ENT) department of University of Port Harcourt Teaching Hospital (UPTH) and Rex Medical center Port Harcourt, from January 2006 to December 2011. The records of all patients that presented to both centers with history of FB ingestion were retrieved from admission registers, theatre records and case files. Demographic and clinical data were documented and simple statistical tables were used to illustrate the data. Data analysis was done using SPSS for windows 15. Results: The records of 70 patients were retrieved out of 2,400 patients that presented with ENT emergencies giving a prevalence of 2.92%. The total ENT cases seen within the study period were 22,200 cases giving a prevalence of 0.32%. Fifty five patients had radiologic confirmation of foreign bodies in their esophagus and 15 were further confirmed during esophagoscopy. There were 44 males and 26 females with Male: female ratio of 1.7:1. The age range was 1- 65 years with a mean of 23.15 ± 14.24 years. Majority of the foreign bodies 60 (85.71%) were impacted in the cricopharyngeal sphincter of the esophagus. Dentures ranked highest among the adult population, 10 (14.29%) cases while, metallic objects excluding coins ranked highest in the pediatric population, 21 (30%) cases. Forty (57.14%) cases presented to the hospitals after 72 hours. Only 66 (94.29%) patients’ foreign bodies could be extracted. There was failed extraction in 4 (5.71%) cases. Complications occurred in 9 (12.86%) cases. Conclusion: The management of impacted esophageal foreign bodies with rigid esophagoscopy was an effective procedure despite its challenges. Public enlightenment campaigns are necessary to help reduce the incidence and encourage early presentation to hospitals.