Abstract
Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging.
Highlights
Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges
The FBs were impacted at the esophagus in 18 (56.2%) patients (9 in the upper esophagus and 9 in the middle esophagus), at the pharynx in 7 (21.8%) patients, and at the air way in 7 (21.8%) patients (3 left main bronchi, 3 right main bronchi, and 1 trachea)
Endoscopy has been the mainstay of management of aerodigestive foreign bodies [3, 4, 10,11,12,13,14,15,16,17]
Summary
Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality in the two extremes of life and pose diagnostic and therapeutic challenges [1]. The ingestion and aspiration of FBs occur most commonly in children’s population, especially in their first six years of life [1,2,3] They are not so uncommon in adults [4, 5]. There is a distinct group of patients such as young Muslim ladies who frequently use Hijab pins who are being recognized and are at risk [8,9,10,11]
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