Application of point-of-care ultrasound for different types of esophageal foreign bodies: three case reports: A CARE-compliant article

Abstract

RATIONALE: Esophageal point-of-care ultrasound (POCUS) has recently been reported as a useful, quick, safe, and simple technique to detect esophageal foreign bodies (FBs). However, case series to detect esophageal FB using POCUS have been rarely reported. Chicken bones and pills, especially, have not yet been reported as esophageal FBs. The objective of this case series was to describe the POCUS findings of 3 different materials-food, pill, and chicken bone. <br>PATIENT CONCERNS: Case 1, a 75-year-old woman with odynophagia and neck pain occurring 30 min after eating chicken porridge; Case 2, a 32-year-old woman with neck discomfort occurring 2 h after taking a pill; Case 3, a 29-year-old woman reporting FB sensation in the neck that occurred 1 h after eating sausage and rice soup. <br>DIAGNOSIS: Case 1. Cervical esophageal FB (chicken bone), Case 2. Cervical esophageal FB (oral pill), Case 3. Cervical esophageal FB (food). <br>INTERVENTIONS: Case 1. POCUS, urgent esophagogastroduodenoscopy (EGD) with alligator forceps. POCUS findings; hyperechoic material (suspected FB) that did not disappear by swallowing and esophageal dilatation with pooling of secretions. Case 2. POCUS. POCUS findings; hypoechoic material (suspected FB) that did not disappear by swallowing, and esophageal bulging above the FB, especially observed in the longitudinal view. Case 3. POCUS. POCUS findings; hyperechoic material (suspected FB) with reverberation artifact that did not disappear with swallowing efforts. Prior FB esophageal bulging with persistent air-fluid level was especially observed in the longitudinal view. <br>OUTCOMES: Case 1. FB was removed by EGD with alligator forceps. Case 2. Symptoms disappeared under observation without EGD. Follow-up POCUS revealed normalized bulging esophagus. Case 3. These symptoms improved after vomiting a large piece of food material. Three patients were discharged without complications. <br>LESSONS: In this case series, the impacted materials were chicken bone, pill, and food. However, POCUS findings were similar (esophageal dilation, hyperechoic or hypoechoic lesion with mixed echogenic contents in food or secretion, and no change with swallowing efforts). A longitudinal view was useful to assume the presence of cervical esophageal FB in all three cases. Thus, POCUS findings could be indirect signs of a FB in the esophagus.