Case Report: Anaesthetic management of a Rare Oesophageal Foreign Body Impaction:

Abstract

Foreign body impaction is a common and potentially fatal condition encountered by both anaesthetists and surgeons. Skilled airway management is vital to avoid catastrophic outcomes. Children less than five years of age are particularly vulnerable. We report the anaesthetic challenges and management of a 2 year old boy with a rare oesophageal foreign body impaction- a peg pin at the level of the C6 vertebra. The impaction affected the trachea resulting in tracheal narrowing just below the vocal cords. This was associated with a difficult intubation and inability to access the trachea with conventional sized endotracheal tubes. The child suffered bradycardia and laryngospasm during the course of intubation which was successfully managed. Endotracheal Intubation was later successful with a smaller sized endotracheal tube but the patient had oesophageal laceration during the foreign body removal. We conclude that the delicate nature of aero-digestive system must be taken into consideration in patients with foreign body impaction and advice careful management and availability to modern intubation and resuscitation facilities.

Keywords: laryngospasm, bradycardia, foreign body impaction, difficult intubation