Blister-Wrapped Tablet Struck in esophagus

A 23 year old male presented with acute and absolute dysphaia for 3 hours. He said that he had taken few pills for GI disturbance which led to this problem. Considering the fact that tablets are radioluscent, and not yield anything on imaging, an X ray soft tissue neck was nonetheless requisitioned. The xray on initial evaluation seemed just fine. However closer scrutiny revealed an interesting foreign body in upper esophagus. A tablet only, but in its blister pack. The air around the tablet in the blister pack was seen as tram track sign around the radioluscent tablet itself. Removing it was a tough task too as the sharp edges of the tough blister pack would'we torn the esophageal wall upon withdrawing. The edges were rolled up and guided into the esophageal speculum for removal. The patient had infact taken the tablets in a small envelope from the chemist and drained the pills down his throat directly from the envelope without realising that one was still in its pack.
Dr Harpreet S Kochar
Dept of ENT and Head Neck Surgery
Kailash Hospital (Greater Noida) and Delhi ENT hospital (Jasola, New Delhi)
Ph: 09873898361

Esophageal Perforation Caused by a Blister-Wrapped Tablet