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BMJ Case Reports 2012; doi:10.1136/bcr.11.2011.5235
  • Reminder of important clinical lesson

Procedural sedation associated displacement of sharp oesophageal foreign body

  1. Atul Khullar3
  1. 1Pediatrics Department, Military Hospital, Ambala Cantt, India
  2. 2Pediatrics Department, Military Hospital, Saugor, Madhya Pradesh, India
  3. 3ENT Department, Military Hospital, Saugor, Madhya Pradesh, India
  1. Correspondence to Dr Vishal Sondhi, dr.sondhi{at}yahoo.co.in

Summary

Oesophageal foreign body is a common clinical problem. The therapeutic intervention varies from endoscopic removal to observation for spontaneous passage of foreign body. The authors illustrate a case of sharp board pin ingestion by a child, which stayed impacted at C7–T1 level for 8 h with indentation of tracheal mucosa. However, upon administration of midazolam and ketamine for procedural sedation, the pin spontaneously advanced to stomach when muscle relaxation had set in. A few oesophageal mucosal erosions were noted on the endoscopy. The foreign body could not be retrieved by the procedure and was spontaneously egested impacted in faeces. This case presents a distinctive hazard associated with procedural sedation for a foreign body in aero-digestive tract, where the associated muscle relaxation can lead to complications due to spontaneous movement of foreign body.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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