A press-through-pack in the larynx

Cut endotracheal tube for endoscopic removal of an ingested push-through pack

A 52-year-old female presented to our clinic after accidentally ingesting a push-through pack (PTP). After determining that the PTP was present in the stomach, we successfully and safely removed it endoscopically by using a handmade endoscopic hood fashioned from a cut endotracheal tube. Foreign body ingestion is a common clinical problem, and most ingested foreign bodies pass spontaneously. However, the ingestion of sharp objects, such as PTPs, increases the risk of complications, and urgent endoscopy is recommended to remove such objects. Previous studies have reported the use of other devices, both commercial and handmade, for the safe endoscopic removal of foreign bodies. The novel design of our handmade hood for the removal of the PTP, which was fashioned from a cut endotracheal tube, was beneficial in terms of maintaining a wide visual field, patient safety and tolerance, and easy preparation compared to previously reported commercial and handmade devices. It may be a viable and safe device for the retrieval of PTPs and other sharp foreign bodies.

Foreign body ingestion of blister pill pack causing small bowel obstruction

We report a case of foreign body ingestion of a blister pill pack, causing small bowel obstruction. A 76-year-old woman on multiple medications presented with 3 days of progressive abdominal distention, nausea, and vomiting. A computed tomography (CT) scan demonstrated small bowel obstruction with a distinctive metallic foreign body in the distal ileum with associated wall thickening and mesenteric inflammatory changes. At exploratory laparotomy, an impacted, intact blister pill pack was removed from the distal ileum. The ingestion of blister pill packs has been associated with a range of clinical and imaging findings. To our knowledge, this is the only reported case of CT diagnosis of small bowel obstruction caused by blister pack ingestion. Early recognition of the imaging findings of an ingested blister pill pack is important to expedite appropriate management.

Unusual case of coin in larynx (glottic chink) presenting as Dysphagia

Foreign body larynx is a rare condition in adults - inhalation of coin and impaction of the coin in the glottic chink is more rare finding. But this patient presented with difficulty in swallowing and speech, without any respiratory trouble - Hence the case is reported.