Foreign body impaction arising in adulthood: A result of neonatal repair of tracheo-oesophageal fistula and oesophageal atresia

Over a 3-month period, four patients presented to Salisbury District Hospital with symptoms of oesophageal foreign body impaction and dysphagia for solids. in their first few days of life all four patients had undergone successful operations for the repair of congenital oesophageal atresia with or without a tracheo-oesophageal fistula. Despite our efforts, the previous medical records were unavailable to ascertain the exact form of surgery each patient had received. All four patients had flexible oesophagogastroscopy by one of the authors (RAF). Three were found to have a food bolus obstructing the oesophagus, lodged above or within a ring stricture at the presumed level of their surgical repair and oesophageal anastomosis. The fourth patient had a ring stricture only; it was assumed that the food bolus had become disimpacted. All four patients had successful dilatations using thermoplastic oesophageal dilators. After the procedure all the patients were symptom free and remain so at varying lengths of follow-up. Case studies of these patients are presented below along with a review of the literature concerning the relatively rare presentation of dysphagia in adults who had previously undergone neonatal surgery for congenital oesophageal anomalies.