WARNING: This story contains a graphic medical image some readers may find disturbing.
When a 40-year-old woman came to the emergency department complaining of difficulty swallowing, doctors weren’t sure what happened.
The woman from the United Kingdom said she felt like there was something stuck in her throat, but could breathe normally, drink liquids and still move her neck, according to a case report in BMJ Case Reports. She knew that something had happened after she swallowed her Tramadol painkiller tablets at night, but wasn’t sure what.
The doctors X-rayed her chest and neck, but the scans looked normal. Even a nasendoscopy — a test where doctors slide a tiny camera through your nose to look at your throat — revealed nothing unusual.
They decided that she had likely gotten an abrasion in her esophagus as she swallowed her pill, and asked her to come back in 48 hours if her symptoms didn’t improve.
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They didn’t after three days, so she came back. Doctors admitted her to hospital, where they gave her steroids and painkillers until she had improved enough to go home. She also took a test — a “barium swallow” — in which a patient is asked to drink barium sulfate, a chemical that shows up clearly on X-rays to help doctors diagnose problems with the throat, swallowing or other digestive issues.
Again, the test was normal.
So doctors turned once again to cameras — this time examining her upper digestive system with an oesophagogastroduodenoscopy (OGD), where a camera is inserted through the patient’s mouth.
This time, the image was clear: a foil blister pack, full of pills, was lodged in the woman’s throat.
“Everyone was surprised when it was discovered at OGD!” wrote the case study authors.
So was the patient:
“I had no idea I swallowed this! It was a very frightening three weeks and I couldn’t believe when I saw the picture!”
Doctors were able to remove the foil packet without any trouble, 17 days after the woman had swallowed it.
Having a foreign object stuck in your throat can be very dangerous, the report’s authors warn, as it might rupture the esophagus, obstruct the airway, or cause a host of other issues.
They say this woman’s case shows that it’s important not to rely completely on a barium swallow test when someone complains that they have something stuck in their throat, as the test can miss things, most commonly fish bones.
The case report does not explain how the woman managed to swallow a whole packet of pills, foil and all, and apparently not know it. It only mentions that she swallowed her pills in the middle of the night.