Resident Boston University Medical Center Boston, Massachusetts
Objective: Esophageal foreign bodies can have devastating consequences. We describe a case of an esophageal foreign body that led to a spinal epidural abscess, and a novel technique using a right-angle probe to retrieve the object when the shape and position of the object precluded standard instrumentation.
Method: Case report.
Results: We present a case of a 52-year-old man with a history of schizoaffective disorder and polysubstance use disorder who presented with quadriparesis after being found down. CT spine and MRI demonstrated a ring-shaped foreign body in the esophagus at the level of C5-C7 and an epidural fluid collection from C2-T2. The patient was emergently taken for a C4-T1 laminectomy and rigid esophagoscopy. A plastic water bottle cap was found within the esophagus at 15cm from the incisors, with the cap edges toward the spine. Initial attempts at retrieval failed using alligator and cupped forceps due to the smooth surface of the foreign body. A right-angle probe was then used to hook the free edge of the cap and remove the foreign body to the pharynx.
Conclusion: This is a unique case as the esophageal foreign body, a water bottle cap, led to a spinal epidural abscess and could not be retrieved with standard instrumentation. The described method, using a right-angle probe to remove the foreign body through an esophagoscope, is an important technique for retrieval foreign bodies that cannot be grasped with standard instrumentation.