Pill in the pyriform sinus, What anaesthesiologists should know about it

Abstract

In a 51-year-old male scheduled for elective surgery, a video laryngoscopy showed a foreign body near the right pyriform sinus. It was removed with Magill forceps and found to be remnants of the tablet. He had taken a tablet of Pantoprazole 2 hours prior to surgery with sips of water. In the postoperative period, he confirmed he had no difficulty in swallowing and his lower cranial nerve examination was normal. He did mention he needed more water to swallow the tablet given prior to surgery. Our departmental protocol has been allowing sips of water for tablets on the morning of surgery. The factors like size of the tablet, amount of water, and position of the head do affect the swallowing of a tablet. Following this incident now we provide clear instructions to our patients about morning oral medications.