A 44-year-old man with a history of alcohol abuse and smoking was receiving follow-up
at our hospital owing to chronic pancreatitis. As he was suffering vague dyspeptic
symptoms, he underwent esophagogastroduodenoscopy. He had not previously undergone
any form of surgery. The endoscopic examination identified a slightly depressed hyperemic
esophageal lesion, 1.5 cm in diameter, 31 cm distal to the superior dental arcade,
which did not stain on exposure to Lugol’s solution (Figure [1 1
Figure 1 A slightly depressed, hyperemic early esophageal cancer. Lugol staining was negative
A check-up endoscopy was carried out three months later; the patient was completely
asymptomatic. The examination revealed a white, regular scar in the area corresponding
to the previous mucosectomy (Figure [2 3
Figure 2 Check-up endoscopy at the site of the previous mucosectomy
Figure 3 The mucosectomy site after biopsy. Note the cotton thread that was underneath the
reepithelialized mucosa
Foreign bodies in the esophagus are a common problem, mainly in children. Adults are
less likely to swallow undigestible items deliberately, with the exception of a few
groups in which there is clearly a high risk - individuals with psychiatric illness,
abusers of drugs or alcohol (as in this patient), and prison inmates. Esophageal impaction
occurs more frequently in adults when there is pathological narrowing of the esophagus,
as in peptic stricture or distal esophageal ring [2 3
