title: Procedural sedation associated displacement of sharp oesophageal foreign body.
abstract: 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 C(7)-T(1) 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.
authors.affiliation: Pediatrics Department, Military Hospital, Ambala Cantt, India. dr.sondhi@yahoo.co.in
authors.forename: Vishal
authors.initials: V
authors.lastname: Sondhi
authors.forename: Suprabha Kumari
authors.initials: SK
authors.lastname: Patnaik
authors.forename: Atul
authors.initials: A
authors.lastname: Khullar
mesh_terms: D016292:Procedural Sedation; D004945:Esophagoscopy; D004947:Esophagus / Q000293:injuries*; D005547:Foreign Bodies / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D013270:Stomach