A case of esophageal foreign body causing tracheo-esophageal fistula.

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We reported a case of a cervical esophageal foreign body which had developed an esophageal perforation and a tracheo-esophageal fistula. The patient was 56 years old male and had been in a mental hospital because of mental retardation for 26 years. He misswallowed an artificial tooth, but his chief physician and nurses did not notice it. The esophageal foreign body could not diagnosed for a month. He was introduced to our hospital on the 22th June 1988, we tried to remove the forein body using rigid esophagoscope, but it ate into the esophageal mucosa, so we could not remove it. On the next day, the foreign body was removed by means of lateral neck incision. The esophageal perforation and the tracheo-esophageal fistula were repaired using Latissimus dorsi myocutaneous flap 5 days later. It was fortunate that he did not fall pneumonia or mediastinitis after the operation. The esophagogram three weeks after the operation did not reveal leak of contrast media or stenosis of the esophagus. He had been troubled with misswallowing caused by post-operative r-RLN palalysis, so we tried a percutaneous intracordal injection technique for improvement of glottis closure during swallowing. He was discharged from our hospital 16 weeks after the admission, We feel keenly to need the enlightenment about the danger of the artificial tooth which may be a foreign body of the esophagus.
特定非営利活動法人日本気管食道科学会の論文