Is That an Oesophageal Foreign Body I See?

The presence of an oesophageal foreign body is a medical emergency requiring urgent evaluation and treatment and in cases with complications such as migration of foreign body or oesophageal perforation, surgical intervention may be necessary. We present a case of a 23 year old Chinese female with no significant past medical history who presented to the emergency department with central chest discomfort for a week. She had throat discomfort prior which started after she accidentally swallowed a small piece of cockle shell while eating. CXR and lateral neck X-ray were done which did not reveal any abnormalities. A referral was made to the ENT team to rule out the possibility of a foreign body, and a nasoendoscopy was performed which did not reveal any abnormalities. In view of her persistent symptoms, a CT chest was performed which revealed a curvilinear radio dense opacity at the aortopulmonary window measuring 1.0cm, which is suspicious for a foreign body. The differential for a radio dense opacity in the aorto-pulmonary window is calcification of the ligamentum arteriosum, which was the final diagnosis after exclusion with further investigations inpatient.