Sehmus Olmez  ( Department of Gastroenterology, Health Sciences University, Adana City Training and Research Hospital, Adana, Turkey )
Bunyamin Saritas  ( Department of Gastroenterology, Tarsus State Hospital, Mersin, Turkey )

https://doi.org/10.47391/JPMA.04-552

 

Madam, Shirdan is a traditional food, common in southern parts of Turkey. It is consumed as a fast food and prepared by cleaning the lamb’s stomach and filling it with spicy rice. We report two cases of atypical foreign bodies (Shirdan) located in the esophagus. In the known literature, Shirdan has not ever been reported as an oesophageal foreign body.

Case-1: A 46 years old woman was admitted to the emergency department with dysphagia and drooling shortly after eating Shirdan. As the food was hot, she swallowed it without chewing. An urgent endoscopy was performed which revealed a Shirdan just below the upper esophageal sphincter (Figure 1).

Shirdan pieces were pushed into the stomach by the biopsy forceps.

Case-2: A 73 years old man presented to the emergency department with dysphagia and chest pain after eating Shirdan. As he did not have enough teeth he ate it without chewing it well. Clinical examination and laboratory tests were normal. An urgent endoscopy showed the Shirdan in the middle esophagus (Figure 2a).

Shirdan was removed with a snare. (Figure 2b). At a second-look endoscopy, a stricture was seen at 27 cm away from incisors (Figure 2c).

Esophageal foreign bodies (EFB) are seen frequently and they are one of the common causes of urgent endoscopy. Diagnosis and treatment of EFB should be made as early as possible to avoid serious complications, such as perforation. Routine radiological examinations are not always necessary for diagnosis of EFB before endoscopy. Flexible endoscopy is used for both diagnosis and treatment of EFB which can be applied to most patients.^1,2

Oesophageal foreign bodies are more common in children. Among adult patients, the highly susceptible subjects are psychiatric patients, mentally retarded patients and the elderly with chewing problems. This was seen in our case 2.³ In western society, the most common cause of EFB in the elderly is a piece of meat and other kinds of food bolus as seen in our case 1.¹ The other reasons are underlying esophageal diseases such as carcinoma, stricture and motility disorders as in our case 2.^2,3

In conclusion, the case presented was a rare case of an oesophageal foreign body, Shirdan.

 

Disclaimer: Patients gave written consent for images or other clinical information relating to their cases to be reported in a medical publication.

Conflict of Interest: None.

Funding Disclosure: None.

 

References

 

1.      Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011;73:1085-91. doi: 10.1016/j.gie.2010.11.010.

2.      Pfau PR. Removal and management of esophageal foreign bodies. Tech Gastrointest Endosc 2014;16:32-9. Doi: 10.1016/j.tgie.2013.10.004

3.      Li ZS, Sun ZX, Zou DW, Xu GM, Wu RP, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc 2006;64:485-92. doi: 10.1016/j.gie.2006.01.059.