Pharyngo-oesophageal Foreign Bodies: Implications for Health Care Services in Nigeria

Background: Pharyngo-oesophageal foreign body is the commonest endoscopic surgical emergency in otorhinolaryngological practice in Nigeria. Its implication in health care services of Nigeria is highlighted from the experiences of Usmanu Danfodiyo University Teaching Hospital Sokoto Nigeria. Method: Clinical records of patients seen in the Ear, Nose and Throat department of Usmanu Danfodiyo University Teaching Hospital Sokoto from January 1999 to May 2003 with suspected or confirmed history of foreign body ingestion who were prospectively recruited were reviewed. The patients were subjected to thorough history, clinical examination and radiological investigation of the neck and chest. Rigid pharyngo-oesophagoscopy and removal under general anaesthesia was carried out where indicated while some were observed for the foreign body to be passed in stool. Results: A total number of 75 cases were seen. There were 50 males (66.7%) and 25 females (33.3%). Their ages ranged from 6 months - 90 years. Age group of 0-5 years accounted for 53.3%, while 0-10 years accounted for 68%. Coin (65.3%) was the commonest foreign body occurring mainly in the paediatric age group followed by bones (17.3%) and meat bolus (8%) in adults. Meat bolus was the only impacted foreign body amongst the elderly patients aged between 70-90years.The duration of impaction ranged from a few hours to seven years. Compared with other reports, there were no foreign bodies of dental origin, no complications or mortality in their management. Conclusion: Pharyngo-oesophageal foreign body impaction is the commonest indication for emergency surgical endoscopy. A functional up to date endoscopic unit backed by skilled manpower and easily accessible to the populace is advised.Fond: Le corps \ue9tranger Pharyngo-oesophagien est la chirurgicale endoscopique d'urgence la plus commune dans la pratique otorhinolaryngologique au Nig\ue9ria. Son implication dans les services de sant\ue9 du Nig\ue9ria sont accentu\ue9es \ue0 partir des exp\ue9riences \ue0 l'H\uf4pital d'Enseignement de l'Universit\ue9 d'Usmanu Danfodiyo, Sokoto, Nig\ue9ria. M\ue9thode: Les fiches cliniques des malades vues dans le d\ue9partement d'oreille, de nez et de pharynx de l'H\uf4pital d'Enseignement de l'Universit\ue9 d'Usmanu Danfodiyo, Sokoto \ue0 partir de janvier 1999 \ue0 mai 2003 avec l'histoire suspect\ue9e ou confirm\ue9e de l'ingestion de corps \ue9trangers qui ont \ue9t\ue9 prospectivement recrut\ue9s \ue9taient pass\ue9s en revue.Les malades ont \ue9t\ue9 soumis \ue0 l'histoire compl\ue8te, \ue0 l'examen clinique et \ue0 la recherche radiologique sur le cou et le coffre. Une pharyngo-oesophagoscopie rigide et le d\ue9placement sous l'anesth\ue9sie g\ue9n\ue9rale ont \ue9t\ue9 effectu\ue9s o\uf9 indiqu\ue9s tandis que certains \ue9taient observ\ue9s pour le corps \ue9tranger \ue0 passer dans les selles. R\ue9sultats: Un nombre total de 75 cas ont \ue9t\ue9 vus. Il y avait 50 m\ue2les (66,7%) et 25 femelles (33,3%). Leurs \ue2ges se sont \ue9tendus de 6 mois - 90 ans. La cat\ue9gorie d'\ue2ge de 0-5 ans a repr\ue9sent\ue9 53,3%, tandis que 0-10 ans ont repr\ue9sent\ue9 68%. Le bruit de pot f\ueal\ue9 (65,3%) \ue9tait le corps \ue9tranger le plus commun se produisant principalement dans la cat\ue9gorie d'\ue2ge p\ue9diatrique, suivie des os (17,3%) et du bol de viande (8%) dans les adultes. Le bol de viande \ue9tait le seul corps \ue9tranger effectu\ue9 parmi les vieux malades \ue2g\ue9s entre 70-90 ans. La dur\ue9e de l'impaction s'est \ue9tendue de quelques heures \ue0 sept ans. Compar\ue9 \ue0 d'autres rapports, il n'y avait aucun corps \ue9tranger d'origine dentaire, aucunes complications ou mortalit\ue9 dans leur traitement. Conclusion: l'impaction de corps \ue9tranger Pharyngo-oesophagien est l'indication la plus commune pour l'endoscopie chirurgicale de secours. Une unit\ue9 endoscopique r\ue9cente et fonctionnelle soutenue par la main d'oeuvre habile et facilement accessible \ue0 tout le monde est conseill\ue9e