Ingested sharp foreign body presented as chronic esophageal stricture and inflammatory mediastinal mass for 113 weeks: Case report

Abstract

Introduction

Impacted foreign bodies in the esophagus have the potential to cause serious complications. Ingested sharp objects carry the risk of acute complications as: perforation, acute mediastinitis, and acute bleeding. Rarely, such foreign bodies might migrate through the esophageal wall and present as chronic esophageal foreign body.

Case presentation

We present a case of a 36-month-old girl presented with solid food dysphagia and regurgitation proved to be secondary to esophageal stricture after 26 months of accidental ingestion of aluminum can tab which has migrated through the wall of the upper esophagus into the mediastinum. After two trials of endoscopic treatment; she underwent thoracotomy and partial esophagectomy. Multiple trials of dilation and Mitomycin C injection were followed because of re-stricture.

Conclusion

Foreign body impaction or secondary stricture needs to be considered in the differential diagnosis of children presenting with new onset dysphagia and regurgitation. Metallic Foreign body might be even radiolucent. Practitioners should keep a high index of suspicion for a retained esophageal FB in the child with gastrointestinal or respiratory symptoms that do not respond to standard therapy.

Highlights

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  Foreign body impaction needs to be considered in the differential diagnosis of dysphagia and regurgitation.

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  Metallic FBs might be even radiolucent, and X-ray might not be enough to exclude FB ingestion.

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  Impacted FB in the esophagus may remain asymptomatic for some time and become symptomatic only when complications develop.

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  Chronic esophageal foreign body can lead to complications that may enforce the physicians to go for aggressive surgeries.