New Delhi: In one of the rarest reported cases of foreign body ingestion, a 77-year-old man accidentally swallowed a key attached to a full keychain, likely due to dementia.
The patient experienced difficulty swallowing food, water, and even had trouble breathing. An immediate X-ray conducted by the attending general physician revealed a metallic object lodged in the upper esophagus — a key with a full keychain.
The patient was referred without delay to Dr. Shubham Vatsya, a gastroenterologist, who performed an emergency endoscopy. The object was safely retrieved in under a minute.
“Such cases in elderly patients with cognitive decline are extremely rare, and the risks can escalate very quickly,” said Dr. Shubham. “Fortunately, the quick diagnosis and immediate referral made all the difference.”
He added, “solving such a case only becomes possible with expertise of the gastroenterologist to perform endoscopic foreign body removal. This case was solved in less than one minute by the specialised gastroenterologist with assistance of expert endoscopy technicians.”
Foreign body ingestion is more common in children, but it can also occur in older adults, particularly those with neurological impairments or psychiatric disorders. In the elderly, diminished swallowing reflexes and cognitive changes may increase the risk of accidental ingestion.
In most cases, small ingested objects pass through the gastrointestinal tract without intervention.
However, when sharp, metallic, or bulky items become lodged in the esophagus or airway, they can cause obstruction, perforation, or even life-threatening complications. Symptoms may include chest pain, difficulty swallowing, drooling, coughing, or respiratory distress.
Endoscopy is the preferred method for removing ingested foreign bodies. It allows direct visualization and extraction using specialised tools, with minimal invasiveness and high success rates when performed promptly.
In this case, within just 15 minutes of the procedure, the patient’s ability to swallow and breathe had returned to normal. The case underscores the need for early detection and the importance of close coordination between general physicians and gastroenterologists.
This incident serves as a reminder that foreign body ingestion in elderly individuals, though uncommon, can be fatal without rapid medical response.