title: Visual failure in the elderly and dysphagia.
abstract: A 91-year-old man presented with a history of acute dysphagia. Clinical examination found reduced oxygen saturations and lung basal crepitations. Blood tests revealed mild anaemia, leukocytosis and acute renal failure. Chest X-ray demonstrated two oesophageal foreign bodies (FBs) and consolidation at the left lung base. Dysphagia resolved following the removal of two coins at oesophagogastroduodenoscopy, the man did not recall ingesting coins. His coin ingestion was attributed to poor visual acquity and he was referred for eye examination and advised to keep coins separate from food and medication. Children and the aged are likely to swallow FBs; causes of ingestion include reduced ability to chew and/or distinguish between objects. Most FBs pass spontaneously, however those that become stuck are likely to impact in the oesophagus. It is important to consider visual acuity for both compliance with medication and to prevent ingestion of FBs.
authors.affiliation: Department of Anaesthetics, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: David G
authors.initials: DG
authors.lastname: Gore
authors.forename: Aruna
authors.initials: A
authors.lastname: Maharaj
authors.forename: Nicola
authors.initials: N
authors.lastname: Doddridge
mesh_terms: D000369:Aged, 80 and over; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D004947:Esophagus; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011859:Radiography; D014786:Vision Disorders / Q000150:complications*
references.citation: Ann Otol Rhinol Laryngol. 2010 Feb;119(2):93-8
references.pmid: 20336919
references.citation: Can Fam Physician. 1986 Apr;32:811-4
references.pmid: 21267132
references.citation: Nepal Med Coll J. 2010 Mar;12(1):38-41
references.pmid: 20677608
references.citation: Surg Endosc. 2007 Mar;21(3):455-60
references.pmid: 17131048
references.citation: Surg Endosc. 2007 Nov;21(11):2026-9
references.pmid: 17393244
references.citation: World J Surg. 1996 Oct;20(8):1001-5
references.pmid: 8798356
references.citation: MedGenMed. 2003 Jun 06;5(2):3
references.pmid: 14603102
references.citation: Arch Otolaryngol Head Neck Surg. 1994 Jan;120(1):96-101
references.pmid: 8274262
references.citation: J Med Assoc Thai. 2000 Dec;83(12):1514-8
references.pmid: 11253892
references.citation: Int J Pediatr Otorhinolaryngol. 2012 May 14;76 Suppl 1:S84-91
references.pmid: 22365376
references.citation: Dig Liver Dis. 2012 Jun;44(6):482-6
references.pmid: 22321620
references.citation: ScientificWorldJournal. 2012;2012:102642
references.pmid: 22593662
references.citation: Br J Ophthalmol. 2000 Feb;84(2):165-70
references.pmid: 10655192
references.citation: BMJ. 1991 Jun 1;302(6788):1321-2
references.pmid: 1953854
references.citation: Niger J Clin Pract. 2005 Jun;8(1):56-9
references.pmid: 16392458
references.citation: Age Ageing. 2003 Jan;32(1):26-30
references.pmid: 12540344
references.citation: Trop Doct. 2009 Apr;39(2):97-8
references.pmid: 19299293