Madhya Pradesh: Life-saving surgery to remove knife from food pipe at AIIMS, Bhopal

BHOPAL: A life-saving surgery has been performed at AIIMS, Bhopal, to remove a knife from the food pipe, medically known as the oesophagus.

The Ear-Nose-Throat (ENT) department at AIIMS, Bhopal, performed a challenging and life-saving emergency surgery on a 32-year-old male patient.

The patient had come from Chhatarpur district of Madhya Pradesh to the Emergency department of AIIMS, Bhopal. He complained of severe pain in swallowing with inability to swallow anything for two days and was promptly attended to by the department of ENT—Head & Neck Surgery team.

History of swallowing: The patient revealed a history of swallowing a kitchen knife two days ago. He had been regularly taking anti-psychotic medications for the past two years and was also addicted to alcohol, bidi, gutkha, ganja for the past 10 years. In an X-ray taken of the neck and chest (PA view), a knife-like foreign body was observed in the neck region.

An emergency surgery was planned. First, an endoscopy was done of the food pipe on which one end of a knife (handle end) and a pen refill was seen. The pen refill was removed through the endoscope, but because of the large size of the knife and risk of injury to the foodpipe, surrounding vital organs and major blood vessels, a surgically ‘open approach’ was decided by the ENT team.

The neck was operated on from the left side. The major blood vessels and critical nerves were identified and carefully moved away from the field. Through a 4-cm surgical incision in the food pipe, the knife (14 cm long and about 3.5 cm wide) was removed very slowly and carefully to avoid injury to the surrounding structures. The patient is recovering well and is now being fed through the naso-gastric tube while the food pipe heals.

The team of saviours

The ENT surgical team was headed by Dr Vikas Gupta (additional professor) with Dr Ganakalyan Behera (assistant professor), Dr Shrey (senior resident) and Dr Sandeepan and Dr Prince (junior residents). The anaesthesia team was headed by Dr Ritika (assistant professor) with Dr Manish (senior resident), Dr Aditi, Dr Akhil, and Dr Ria (junior residents).

Long, complicated history: This patient had a long history of ingesting large foreign objects. Two years ago, multiple foreign bodies were removed from his stomach. Multiple foreign bodies ingested by him in the past 6-8 months are still in his abdomen. If the knife had not been removed timely as an emergency measure, it would have torn through the food pipe and also caused life-threatening injuries to the major blood vessels in the region. A second surgery is planned to remove the other objects from his stomach once the neck area heals. The patient is being evaluated by the Department of Psychiatry.

Director of AIIMS, Bhopal, Prof. Sarman Singh congratulated the ENT team on its quick action and timely life-saving intervention.