Absolute dysphagia after adenotonsillectomy due to a forgotten gauze pack impacted in the esophagus

ObjectivesWe present a rare case of absolute dysphagia after adenotonsillectomy due to a forgotten gauze pack impacted in the esophagus.Case reportA 9 year old girl was presented with absolute dysphagia 15 days after adenotonsillectomy. The parents reported postoperative poor oral intake for semisolids which became absolute for both solids and fluids 4 days after surgery. Clinically, the only positive finding was pooling of saliva in the hypopharynx detected by flexible nasopharyngoscopy. Computerized tomography revealed a retropharyngo-esophageal well defined lesion which was suggested to be localized neck space infection. Rigid esophagoscopy under general anesthesia was done before planned neck exploration to surprisingly reveal an impacted gauze pack surrounded by severe esophageal inflammatory reaction.ConclusionBecause dysphagia was attributed to adenotonsillectomy itself in this case, the diagnosis was delayed for about 15 days. A systematic approach for the management of progressive dysphagia should be considered from non-invasive to more invasive maneuvers and foreign body option should always be borne in mind.