Removal of Six Esophageal Metals in a Four-Month-Old Infant: A Rare Case

This case report details the distinctive and demanding clinical situation involving a four-month-old female neonate. Her chief complaint was a two-day refusal to consume food orally, accompanied by episodes of vomiting following feedings and a sensation of choking in the throat. The referring physician suspected the presence of a foreign body in the patient's esophagus and advised a chest X-ray following a thorough examination. The presence of six hyperdense metallic foreign bodies in the upper, mid, and distal dorsal esophagus was confirmed by subsequent CT thorax imaging. This case was managed through the implementation of a multidisciplinary strategy. A decision was reached to conduct an endoscopic assessment; a substantial foreign object resembling a boulder was detected throughout the procedure, resulting in total obstruction of the esophageal lumen. Despite some challenges, this foreign object was effectively extracted by utilizing a Dormia basket. After that, endoscopy was used to detect five more metallic foreign bodies, all successfully eliminated endoscopically. The postoperative course was characterized by the 24-hour prophylactic Ryles tube insertion, followed by the resumption of breastfeeding. The infant's recovery and positive attitude on the second day following the operation indicate the case's successful resolution, emphasizing the criticality of a timely intervention in similar circumstances. This report underscores the clinical management and treatment of multiple metallic foreign bodies in a pediatric patient while also stressing the importance of prompt diagnosis and interprofessional collaboration in complex and exceptional cases.