Foreign body perforation of the normal oesophagus

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Abstract
Over an 11-year period, 12 patients with foreign body perforation of apreviously normal oesophagus were treated in our institution. The foreignbodies were most commonly bones (10 cases), 5 of which were chicken bones;other species were pigeon, rabbit, veal, pork and fish (one each); 2perforations were due to swallowed dentures. The mean age was 60 years(range 42-73) and 6 patients were female. A degree of psychosocialdysfunction was present in 3 patients. Seven patients presented late (≫48 h after ingestion). The commonest presenting symptoms were fever andpain (8 patients). Other symptoms included dysphagia (7), respiratorydistress (3), and late cervical abscess formation (3). The diagnosis wasestablished by contrast oesophagography or rigid oesophagoscopy. A third ofthe perforations were cervical, the remainder intrathoracic. All patientswere treated by surgical drainage with or without primary closure of theperforation. There were no operative deaths. Five patients developedpostoperative oesophageal leaks which required reoperation in 1 patient.All patients were well and swallowing normally on discharge from hospital.Follow-up endoscopy or oesophagography was carried out in all patients andconfirmed the absence of oesophageal disorders. Foreign body perforation ofthe oesophagus is a rare but important subentity of oesophageal perforationwhich responds well to surgical treatment.

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