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Hypopharyngeal perforation from a swallowed fork: a brief report and comment

A M Choudhary1, I Roberts, T Gupta

  • 1Department of Medicine Bridgeport Hospital, USA.

Connecticut Medicine
|October 26, 1999
PubMed

Insights

Hypopharyngeal perforation, a rare complication, typically results from endotracheal intubation. This case highlights an unusual cause: a swallowed plastic fork in a psychiatric patient, emphasizing the need for broader differential diagnoses.

Area of Science:

  • Medicine
  • Gastroenterology
  • Otolaryngology

Background:

  • Hypopharyngeal perforations are uncommon but serious complications.
  • They are frequently associated with medical procedures like endotracheal intubation, particularly by less experienced physicians.
  • Common sites of perforation include the pharynx posterior to the cricopharyngeal muscle and the pyriform sinus.

Observation:

  • This report details an atypical case of hypopharyngeal perforation.
  • The perforation was caused by the ingestion of a foreign body, specifically a plastic fork.
  • The patient had a history of psychiatric illness, which may have contributed to the foreign body ingestion.

Findings:

  • The study identifies an unusual etiology for hypopharyngeal perforation.
  • Foreign body ingestion, such as a swallowed plastic fork, can lead to this critical injury.
  • This contrasts with the more common iatrogenic causes related to intubation.

Implications:

  • Clinicians should consider non-iatrogenic causes, including foreign body ingestion, in the differential diagnosis of hypopharyngeal perforation.
  • This case underscores the importance of thorough patient history, especially in psychiatric patients, to identify potential risks.
  • Awareness of such unusual causes can improve diagnostic accuracy and patient management in emergency settings.

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