Complication of an Adult Oesophageal Foreign Body: Place of Cervicotomy

Abstract

<i>Objectives</i>: Our work was aimed at exposing the methods of extraction of a foreign body enclosed in the cervical esophagus and specifying the place of cervicotomy in its management. <i>Observation:</i> We report the case of a 76-year-old patient admitted to the ENT emergency department for sudden onset dysphagia following the ingestion of a foreign body of dental prosthesis type (two teeth). The face and profile cervicothoracic radiography revealed a thickening of the oesophageal lumen associated with a prevertebral hyperclarity at the height of the C8 and D1 vertebrae. After two endoscopic extraction attempts to the rigid tube we performed a cervicothoracic CT that showed the dental prosthesis at the height of C8-D1 associated with a peripheral hyperclarity and a left pneumothorax. The hemoglobin level was 14 g/dl, the prothrombin rate was 84%, the activated partial thromboplastin time was 35 seconds. The cervicotomy allowed us to note a perforation of the esophagus at the height of C8-D1. We made an oesophagofissure that allowed us to extract the prosthesis. The reconstruction of the oesophageal lesion was done in two planes. <i>Conclusion:</i> Denture type foreign bodies carry a risk of perforation, especially when endoscopic extraction is difficult. This risk is all the more important when the extraction time is long, when there is a pre-existing oesophageal pathology and by forced extraction maneuvers. Standard surgery is the best way to prevent perforation and septic complications.