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Large Aerodigestive Tract Foreign Body Extraction Complicated by End-Stage Dementia
Dharam Persaud-Sharma1, Sayoni Saha1, Jacob Poynter2
1Department of Anesthesiology, University of Florida, Gainesville, USA.
Cureus
|February 25, 2021
Summary
Foreign body ingestion in the upper aerodigestive tract poses significant risks, especially for patients with dementia. This case highlights challenges in anesthesia management for large foreign body extraction in this vulnerable population.
Area of Science:
- Anesthesiology
- Otolaryngology
- Geriatric Medicine
Background:
- Foreign bodies in the upper aerodigestive tract (UADT) present a critical medical emergency.
- Management is complex due to limited workspace shared by surgeons and anesthesiologists.
- Patients with cognitive impairment, such as end-stage dementia, introduce unique anesthetic challenges.
Observation:
- An 83-year-old female with end-stage dementia and oral fixation presented asymptomatically.
- She had ingested a large foreign object into her upper aerodigestive tract.
- Despite altered mentation, the patient was initially asymptomatic.
Findings:
- The case underscores the difficulties in providing anesthesia for UADT foreign body extraction in patients with dementia.
- Oral fixation in elderly patients with dementia can lead to unexpected and dangerous ingestions.
- Successful extraction required careful anesthetic planning and execution.
Implications:
- This case emphasizes the need for specialized anesthetic protocols for patients with cognitive deficits undergoing foreign body removal.
- It highlights the importance of recognizing oral fixation as a potential risk factor in geriatric patients.
- Improved interdisciplinary communication and preparation are crucial for managing complex airway foreign body cases.
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