Обширное инородное тело пищевода с распространением на гортаноглотку и гортань

Abstract

Foreign bodies of the respiratory tract and esophagus remain one of the pressing problems in medicine, which is associated with the possibility of developing complications that can end in death. We present our clinical observation that demonstrates the long-term presence of a large foreign body fixed in the area of the pharyngeal narrowing of the esophagus and extending into the larynx and the vestibule of the larynx. Patient T., 57 years old, went to the emergency department of the Karachay-Cherkessia Republican Clinical Hospital with complaints of severe sore throat, inability to swallow, excessive salivation, increased body temperature to 37,5 °C, difficulty breathing, mixed shortness of breath, which persist for 3 days. The examination revealed: the epiglottis is mobile, the mucous membrane of the larynx is hyperemic, edematous, with an abundance of saliva, at the level of the vestibular part of the larynx, in the area of the arytenoid cartilage and aryepiglottic folds, an irregular shape was visualized, with smooth edges, a thin, hard whitish plate. Computed tomography of the cervical spine: in the esophagus, at the level of C4-C5 vertebrae, a foreign body with a metallic density of +2900 hU units, elongated, irregular shape, measuring 2.2 by 3.3 cm, with perifocal air bubbles is determined. A preliminary diagnosis was made: Foreign body of the esophagus, laryngopharynx with a spread to the vestibule of the larynx. 3 days after the retention of the foreign body under intubation anesthesia, it is captured using forceps with serrated cups and removed during direct laryngoscopy. There were no complications during the manipulation. The combination of X-ray and endoscopic examinations with the help of innovative medical and diagnostic equipment made it possible to establish a diagnosis in a short time, choose the most effective treatment tactics and remove a foreign body through natural pathways.