The Challenges of Rigid esophagoscopy in the management of esophageal foreign bodies in Port Harcourt

Abstract

Background: Foreign body (FB) ingestion and impaction in the esophagus constitutes an important 
cause of morbidity and mortality worldwide. Most of the impacted foreign bodies in the esophagus 
require endoscopic removal with rigid esophagoscopy. 
Objective: This study seeks to highlight the challenges in the management of esophageal FB using 
rigid esophagoscopy. It will also evaluate the outcome of management. 
Patients and Method: This was a retrospective study of 70 patients with confirmed esophageal foreign 
bodies that were managed in the Ear, Nose and Throat (ENT) department of University of Port Harcourt 
Teaching Hospital (UPTH) and Rex Medical center Port Harcourt, from January 2006 to December 2011. 
The records of all patients that presented to both centers with history of FB ingestion were retrieved 
from admission registers, theatre records and case files. Demographic and clinical data were 
documented and simple statistical tables were used to illustrate the data. Data analysis was done using 
SPSS for windows 15. 
Results: The records of 70 patients were retrieved out of 2,400 patients that presented with ENT 
emergencies giving a prevalence of 2.92%. The total ENT cases seen within the study period were 
22,200 cases giving a prevalence of 0.32%. Fifty five patients had radiologic confirmation of foreign 
bodies in their esophagus and 15 were further confirmed during esophagoscopy. There were 44 males 
and 26 females with Male: female ratio of 1.7:1. The age range was 1- 65 years with a mean of 23.15 ± 
14.24 years. Majority of the foreign bodies 60 (85.71%) were impacted in the cricopharyngeal sphincter 
of the esophagus. Dentures ranked highest among the adult population, 10 (14.29%) cases while, 
metallic objects excluding coins ranked highest in the pediatric population, 21 (30%) cases. Forty 
(57.14%) cases presented to the hospitals after 72 hours. Only 66 (94.29%) patients’ foreign bodies 
could be extracted. There was failed extraction in 4 (5.71%) cases. Complications occurred in 9 (12.86%) 
cases. Conclusion: The management of impacted esophageal foreign bodies with rigid esophagoscopy 
was an effective procedure despite its challenges. Public enlightenment campaigns are necessary to 
help reduce the incidence and encourage early presentation to hospitals.