NEW DELHI: Doctors at Sir Ganga Ram hospital successfully removed a tablet with intact aluminium blister foil cover, which was accidentally swallowed by a 61-year-old man, and was stuck in the narrowest portion of his upper esophagus, by using an innovative endoscopic technique.According to doctors, the patient came to emergency with severe chest discomfort and was unable to swallow anything and was repeatedly spitting saliva. “The aluminium foil was very rigid and had sharp edges. Hence, any forceful removal could have easily injured the esophagus leading to devastating complications like perforation, bleeding, mediastinal infection and sepsis which would have required an emergency surgery with its complications,” said Prof Anil Arora, head of gastroenterology. “Since direct removal from the site of esophagus was dangerous, as there was no room for any endoscopic manoeuvring and removal, we gently and slowly pushed the tablet with intact foil into the stomach. This give us ample room for manoeuvring special accessories,” said Dr Shrihari Anikhindi, Consultant Gastroenterologist and Therapeutic Endoscopist. Once it was inside the stomach, the doctors punctured the aluminium foil using a special endoscopic needle and pushed saline under pressure. This dissolved the inner tablet and it came out of the foil in the stomach cavity. As the foil contents were now empty, doctors were able to fold it, reducing its diameter and inverting the dangerous sharp edges.“Using a special accessory called endoscopic mucosal resection (EMR) cap attached to the endoscope, we were able to safely remove the folded aluminium foil out through the mouth. Confronting a difficult and precarious situation, we were glad to perform a safe and quick removal of foreign body using a safe innovative technique,” said Dr Anikhindi. Prof Arora said, “Surprisingly, this is the second time we are encountering such a case and have been successful using this approach on both occasions. Such cases have not been reported in literature. Since there is no standardised approach to such rare impacted foreign bodies, we had to think out of the box. We had to remove a dangerous impacted foreign bodies while ensuring the safety of the internal lining of the esophagus, stomach and throat.”
Source: https://timesofindia.indiatimes.com/city/delhi/delhi-doctors-remove-aluminum-blister-foil-and-tablet-from-61-year-old-mans-esophagus/articleshow/98217431.cms