Abstract
A 4-year-old child presented to the emergency department with an acute onset of dysphagia and vomiting. A plain X-ray soft tissue neck lateral view revealed a double circular opacity in the cervical oesophagus consistent with an ingestion of multiple foreign bodies. Preoperative planning and SARS-CoV2 testing is of particular importance for the pediatric population and if testing cannot be performed, patients in all age groups should be handled as though they are positive for COVID-19, and appropriate precautions should be taken. The child was taken to the theatre for rigid pharyngo-oesophagoscopy and removal of the coins. After the first coin was removed subsequent endoscopic examination revealed a second coin at the same location. This extremely rare case of two ingested coins becoming impacted with perfect radiological alignment, we would therefore advocate having a low threshold for performing a ‘second look’ endoscopy after removal of the first foreign body with postoperative X-rays.
Highlights
A global pandemic, Covid 19 has become a major concern across the world
Case Report We report a case of 4 year old female child who presented to Department of otolaryngology, Government Medical College, Amritsar, Punjab, North India with the complaints of multiple episodes of vomiting, throat pain and foreign body sensation since 12-14 hours
In present case rigid pharyngo-esophagoscopy was done under general anaesthesia and foreign body removal was performed with forceps
Summary
A global pandemic, Covid 19 has become a major concern across the world. Long term home isolation has potentially increased the risk of domestic accidents in children like lodgement of foreign bodies in Ear, Nose and Throat. As per patient’s father child was apparently alright and playing at home Suddenly she started vomiting and was quite frightened with pale look. On further enquiry and prior assurance to patient she revealed that she kept coins in her mouth while playing. She complained of foreign body sensation and she hid the truth due to fear of scolding. To our surprise the soft tissue radiograph of neck lateral view revealed foreign bodies in oesophagus at the level of seventh cervical vertebra (C7) and first thoracic vertebra (T1) which appeared to be double and superimposed because of irregularity of border of coin (Figure 1). The patient was stable and discharged with adequate medical advice
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