NEW DELHI: Doctors at Sir Ganga Ram Hospital used an innovative endoscopic technique to remove a tablet with its aluminium blister foil cover, which was accidentally swallowed by a 61-year-old man and got stuck in the narrowest portion of his upper esophagus. According to doctors, the patient came to the emergency with severe chest discomfort, was unable to swallow anything and was repeatedly spitting saliva. “The aluminium foil was 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 gave 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 cap attached to the endoscope, we were able to safely remove the folded aluminium foil through the mouth. Confronting a difficult and precarious situation, we were glad to perform a safe and quick removal of a 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 successfully used this approach on both occasions. Such cases have not been reported in literature. Since there is no standardised approach, we had to think out of the box. We had to remove ‘dangerous’ foreign bodies while ensuring the safety of the internal lining of the esophagus, stomach and throat.”
Source: https://timesofindia.indiatimes.com/city/delhi/how-doctors-in-delhi-removed-aluminium-med-foil-61-year-old-swallowed/articleshow/98221277.cms