An unexpected foreign body in the oesophogus: a case report

Area of Science:

• Gastroenterology
• Radiology
• Internal Medicine

Background:

• Esophageal foreign bodies can cause significant obstruction, sometimes without typical symptoms like dysphagia.
• Vegetable matter is a common type of esophageal foreign body.
• Dehydration and electrolyte imbalances can occur secondary to esophageal obstruction.

Observation:

• An unusual case of a patient with total esophageal obstruction due to vegetable matter is presented.
• The patient lacked a history of dysphagia despite complete obstruction.
• A distinctive radiological finding, termed the "inverted wine-glass sign," was noted.

Findings:

• The patient presented with pure water depletion, characterized by dehydration and hypernatremia (Na = 164 mEq/L).
• Other significant findings included normokalemia (K+ = 4.2 mEq/L), acidosis (Serum bicarbonate = 10 mEq/L), uremia (220 mg%), and hemoconcentration (hemoglobin = 18.5 g%).

Implications:

• This case highlights the importance of considering esophageal foreign bodies even in the absence of classic symptoms.
• The "inverted wine-glass sign" may be a useful radiological marker for esophageal obstruction.
• Prompt diagnosis and management, including esophageal lavage and intravenous fluid resuscitation, are crucial for successful outcomes in such cases.