New Delhi: An elderly Sir Gangaram reached the emergency of the hospital with severe chest pain. Nothing was going to be swallowed by him. Saliva was coming out again and again. When the doctors asked, it was found that the 61-year-old man had swallowed the medicine along with its aluminum foil cover. It got stuck in the upper part of the esophagus. The edges of the foil were very sharp, even a slight force would have caused severe damage to the esophagus. The danger was great. A slight mistake could have cost the patient’s life. The doctors took out the tablet with a unique endoscopic technique. The tablet is broken in the stomach and it dissolves. After this the foil was folded inside. Then it was taken out through the mouth through a special accessory. Doctors at Sir Ganga Ram Hospital said that they have come across such a case for the second time. In both the cases, the life of the patient was saved in this manner.
The danger was big, the doctors came up with an idea
According to the doctors, when the patient came to the emergency, his condition was bad. Professor Anil Arora, Head of Gastroenterology at Sir Gangaram Hospital, said, “Forcibly removing the esophagus would have injured it… then complications like bleeding, infection and sepsis would have arisen… surgery would have to be done in an emergency.” Dr Srihari Anikhindi, consultant gastroenterologist and therapeutic endoscopist, said that ‘direct removal (of the tablet) from the esophagus was dangerous as there was no room for any endoscopic manoeuvre. We gently pushed the tablet along the foil towards the stomach. This gave us the space to use maneuvering special accessories. Once the tablet reached inside the stomach, the doctors punctured it with the help of a special needle and then injected saline under pressure. This caused the tablet to dissolve and come out of the foil.
The danger was big, the doctors came up with an idea
According to the doctors, when the patient came to the emergency, his condition was bad. Professor Anil Arora, Head of Gastroenterology at Sir Gangaram Hospital, said, “Forcibly removing the esophagus would have injured it… then complications like bleeding, infection and sepsis would have arisen… surgery would have to be done in an emergency.” Dr Srihari Anikhindi, consultant gastroenterologist and therapeutic endoscopist, said that ‘direct removal (of the tablet) from the esophagus was dangerous as there was no room for any endoscopic manoeuvre. We gently pushed the tablet along the foil towards the stomach. This gave us the space to use maneuvering special accessories. Once the tablet reached inside the stomach, the doctors punctured it with the help of a special needle and then injected saline under pressure. This caused the tablet to dissolve and come out of the foil.
Since the foil was now empty, the doctors folded it so that it became smaller and the dangerous edge folded. Dr Anikhindi said that the aluminum foil was removed from the mouth through the endoscopic mucosal resection cap – a special accessory attached to the endoscope.
Professor Arora told our colleague Times of India that this is the second such case. On both the occasions the patient was relieved by this approach. He said that such cases have not been reported in the medical literature. In the absence of a standard approach, doctors have to innovate.