The Use of Intravenous Nitroglycerin During Endoscopic Removal of Sharp Esophageal Foreign Body: A Case Report

Hamidreza Azizi Farsani; Shayesteh Khorasanizadeh; Sogol Asgari; Faranak Behnaz; Hamideh Ariannia; Zahra  Azizi Farsani; Arash Tafrishinejad

doi:10.18502/jimc.v5i4.11346

Hamidreza Azizi Farsani Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Shayesteh Khorasanizadeh Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Sogol Asgari Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Faranak Behnaz Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Hamideh Ariannia Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Zahra Azizi Farsani Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Arash Tafrishinejad Department of Anesthesiology, School of Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jimc.v5i4.11346

Keywords: Anesthesia, Eating, Foreign bodies, Nitroglycerin

Abstract

Background: Esophageal spasm is a common problem after Foreign Body Ingestion (FBI) and causes difficulties for foreign bodies’ removal by endoscopic intervention. Sometimes, medication may help relieve spasms and facilitate the removal of a foreign body. In the current study, we introduce a patient with esophageal spasm due to FBI for whom intravenous nitroglycerin was used to treat the spasm.

Methods: The patient was a 48-year-old man who was admitted to emergency department of Shohadaye Tajrish academic Hospital, Tehran, Iran due to FBI and following sever mid-anterior neck pain, nausea and drooling. His vital signs were normal and during endoscopic procedure, we noticed a sharp object attached to the wall of the upper third of the esophagus, causing severe spasm. After trying for an hour to remove the glass under general anesthesia, we were not able to remove it. Finally, intravenous nitroglycerin was used to relieve the spasm and it was easily removed after 2 minutes.

Conclusion: Due to inconsistencies in the clinical results of nitroglycerin, and as notable lack of studies are investigating the effectiveness of the intravenous method, we aimed to share our successful experience.