Touro College of Dental Medicine, Hawthorne, New York.
Anesth Prog. 2023 Dec 1;70(4):178-183. doi: 10.2344/anpr-70-03-03.
This case report describes a 51-year-old man who swallowed an amalgam fragment dislodged during dental treatment performed without a throat screen. The patient was transferred to the emergency department, where the foreign body was confirmed to be in the esophagus following radiographic imaging. Foreign body removal from the esophagus is routinely achieved via esophagogastroduodenoscopy (EGD). However, this incident occurred in September 2020, at the height of the COVID-19 pandemic. Because of the patient's preoperative positive COVID-19 test, the option for EGD retrieval was eliminated per hospital protocol. Instead, a noninvasive approach with serial radiographic monitoring was deemed mandatory to observe the fragment as it passed through the gastrointestinal tract, warranted by the small size of the foreign body and the patient's lack of signs and symptoms of respiratory distress. This case report reinforces the importance of using airway protection during every dental procedure. Furthermore, reevaluation of EGD as the gold standard for treatment of ingested small materials may be warranted.
本病例报告描述了一名 51 岁男性,他在未使用咽喉屏的情况下进行牙齿治疗时,吞下了一颗脱落的汞合金碎片。患者被转至急诊部,经影像学检查确认异物位于食管内。食管内异物的常规移除方法是通过食管胃十二指肠镜(EGD)进行。然而,这一事件发生在 2020 年 9 月,正值 COVID-19 大流行期间。由于患者术前 COVID-19 检测呈阳性,根据医院的规定,EGD 取物的方案被排除。相反,根据异物较小且患者无呼吸窘迫症状,选择了通过连续放射影像学监测的非侵入性方法来观察碎片在胃肠道中的移动,这是必要的。本病例报告强调了在每次牙科手术中使用气道保护的重要性。此外,有必要重新评估 EGD 作为治疗摄入小材料的金标准。