The first case is Ms. B.T.H.P (55 years old, Ho Chi Minh City). While having lunch with her family, Ms. P. swallowed the tilapia bone. After unsuccessfully trying to remove the incense, she went to the Emergency Department, Gia Dinh People's Hospital for examination. Through ultrasound, the doctors discovered a foreign object, but she thought it was just a small piece of bone, so she asked to go home to check it herself.
Three days later, she had a sharp pain in her chest, spleen behind her, and a mild fever and returned to the hospital. CT scan showed that the fish bone had landed deep into the esophagus and caused abscesses.
Doctors performed an emergency endoscopy to remove an 18-mm-long foreign object with two warts from the esophagus, helping to avoid open surgery. After endoscopy, Ms. P. was transferred to the Department of Thoracic Surgery - Blood vessels for further monitoring and tube feeding to limit infection. After nearly a week of treatment, she has recovered, eaten and communicated normally.
Dr. Ngo Quang Duy, Deputy Head of the Department of Gastroenterology, Gia Dinh People's Hospital, said that this was a complicated foreign object snoring situation because the bones were long, sharp and located in a difficult-to-reach location. If not removed by endoscopy, it must be surgically removed, causing many risks and costs.
Thanks to the quick and effective coordination between specialties including Emergency, Gastroenterology, Anesthesia and Resuscitation, Endoscopy for function and Thoracic - Blood vessel Surgery, Ms. P. was treated safely.
The second case is Mr. D.H.Tr (47 years old, residing in Hanh Thong ward, Ho Chi Minh City). Mr. Tr. has mental decline and cannot recognize the condition of choking on chicken bones during meals. After showing signs of vomiting and abdominal pain, his family took him to the hospital. Abdominal CT images showed a foreign object in the duodenum.
Doctors performed an emergency endoscopy and successfully removed the chicken bone from the digestive tract. After the procedure, he no longer had a stomachache and returned to normal eating.
Dr. CK2 Chung Hoang Phuong, Department of Gastroenterology, who directly participated in the treatment, said: thanks to the modern imaging diagnosis and endoscopy system and the standardized multidisciplinary emergency procedure, the team of doctors from related departments have coordinated smoothly to handle quickly and effectively. This is a typical example of a case of gastrointestinal emergency that requires interdisciplinary, synchronous and timely treatment to achieve optimal results for the person being treated.
According to Dr. Ngo Quang Duy, about 90% of digestive foreign objects can be eliminated naturally, but the rest can cause complications such as perforation, bleeding, abscesses, digestive leakage. In many cases, endoscopy helps avoid open surgery and reduce the risk. However, when a foreign object persists in the wall or causes serious complications, surgical intervention is needed.
