The woman, from the US state of Ohio, was taken to the emergency room after a “choking episode with persistent coughing”, according to her case in The Journal of Emergency Medicine.
It was noted she had “a history of mental retardation and dysphagia”. Dysphagia means issues with swallowing.
“An X-ray study of the chest showed mild opacity at the left lung base and she was discharged with antibiotics,” researchers wrote.
“She returned to the ED that day with worsening symptoms suggestive of aspiration pneumonia.”
A CT scan revealed “cylindrical objects” in her oesophagus and doctors removed 28 crayons found lodged inside. They were removed via three endoscopies.
“During this time, the patient developed aspiration pneumonia, respiratory distress, and septic shock,” researchers wrote.
It is not clear when, but she later died.
Researchers wrote her death is an example why doctors should check the oesophagus in nonverbal patients presenting with similar issues.
“Delayed recognition of foreign body puts patients at risk for oesophageal perforation, aspiration, airway compromise, infection, sepsis, and death,” researchers wrote.
“In non-verbal patients presenting with upper respiratory symptoms, it is especially important to consider oesophageal foreign body in the differential diagnosis, because this group is high risk for missed diagnosis and complications secondary to the foreign body."
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