An unusual foreign body in the oesophagus

Unusual swallowed foreign bodies are uncommon in normal individuals. They may be encountered in the mentally deranged or the subnormal. A case of an unusual foreign body, two safety pins hooked together, in the upper oesophagus of a 27-year-old lady who looked apparently normal at the time of admission to hospital is reported.

A 27-year-old lady presented with history of discomfort in the throat and difficulty in swallowing for two weeks. She denied having swallowed anything unusual. At the time of admission, she looked mentally normal, with normal behaviour. She had no signs of dehydration. There was tenderness on movement of the trachea. Indirect pharyngoscopy showed minimal pooling in the piriform fossae. Plan X-ray of the neck showed a foreign body in the upper oesophagus: two safety pins hooked together (Fig I and II). Under general anaesthesia, oesophagoscopy was carried and the foreign body was successfully removed. During oesophagoscopy, it was attempted to bring the two limbs of each safety pin together and to get the sharp end of the lower safety pin into the oesophagoscope. Fortunately, the lower safety pin broke at the joint. The upper safety pin was delivered in toto and the lower one in two pieces. The foreign body was tarnished suggesting that it stayed in the oesophagus for two weeks. Figure III shows the foreign body repositioned after removal. Post-operative recovery was uneventful and the patient was discharged home after five days in good condition. We met the patient accidentally after six months. She looked well and mentally stable.