A case of the long time presence of a foreign body in esophagus in an infant

Introduction. Infants learn the world while playing through the taste of objects. If the parents neglect it, the object in the mouth can be swallowed. Foreign bodies in the esophagus are easily diagnosed, as a rule, since immediately after getting stuck they are manifested by salivation, choking, difficulty in passing food. If a foreign body passed into the esophagus being unnoticed, in 20% various complications develop, such as esophagitis, stenosis, organ perforation, esophageal-tracheobronchial fistula, mediastinitis, aortoesophageal fistula, cervical spondylitis.

Material and methods. The article presents a clinical case of the long time presence of a large foreign body in the esophagus of an infant which was simulating respiratory disorders. The child was admitted to a surgical hospital with suspected congenital tracheoesophageal fistula because when swallowing liquid food he did not manifested any complaints typical for foreign bodies in the esophagus: pain in the neck and sternum with irradiation to the interscapular region, difficulty or inability to swallow, urge to vomit, hypersalivation. Mom and doctors were inclined to find other reasons for cough and wheezing which were intensified when the child was eating. The authors discuss features of extraesophageal manifestations of a foreign body in the esophagus as well as diagnostic and therapeutic tactics in such cases.

Conclusion. Even small children can swallow large foreign bodies. While taking anamnesis, especially in children of the first year of life, a doctor should think not only about the syndrome of bronchial obstruction, but also about possible presence of a foreign body in the esophagus if wheezing and coughing attacks appear during meal. Diagnostic algorithm should include X-ray and endoscopic examinations which are effective and minimally invasive and which allow to remove a foreign body, even if it is in the esophagus for a long time.