1 week Ago By Steffy Thevar
Pune: It was supposed to be a delicious wedding feast. But a 70-year-old man found himself in the ICU after swallowing a mutton bone, which then got stuck, horizontally, inside the oesophagus. The sharp bone, some 5cm long, caused a tear in the food pipe and lodged itself just above the heart, with potential risk to major blood vessels and other vital organs.
The horizontal position the bone was in made it impossible for the man to drink water. The incident happened on Feb 24 in Indapur. He was transferred to three different hospitals in two days before he was brought to Sassoon General Hospital (SGH) in the city for emergency surgery .
The SGH doctors first used a CT scan to confirm the position of the bone and proceeded to extract it endoscopically as open surgery was deemed too risky, given the patient's age. Also, because the bone pierced through the food pipe there is still risk of food or water leaking onto vital organs. To avoid this, the doctors have now placed a coated stent to cover the injured part of the oesophagus, until it heals completely.
"The patient was in extreme pain when he was brought to us," said Dr Padmasen Ranbagle, associate professor of general surgery at SGH. "He was also breathless. The bone was protruding through the oesophagus and he was unable to even drink water because the passage had been completely blocked.
Our CT scan showed the bone lodged exactly in front of the heart and major blood vessels. We could see pulsating aorta through the perforation," he said. Dr Ranbagle added that it took two attempts to remove the object.
"In our first attempt, the bone did not move at all. So we used rigid endoscopy to stabilize the food pipe and then with the help of a flexible endoscope, we extracted the bone without injuring any vital structures," he said. After the surgery, the doctors sealed the tear with a self-expanding metallic stent and locked it in place with a clip.
"This stent will stay inside for another six months until the wound is completely healed," Dr Ranbagle said. Sassoon hospital's dean Dr Eknath Pawar said the patient resumed eating a day after the procedure, which was performed on Feb 27. "I would urge everyone to be careful while eating and not to be distracted by conversation or their mobile phone," he said.
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