A Dilemma in the Operating Theater due to Misinterpretation of Radiological Findings in a Patient with Absolute Dysphagia

Videofluoroscopy: As the patient was complaining of absolute dysphagia, we went for videofluoroscopic swallowing study (VFSS).Swallowing studies demonstrated absolute dysphagia, with no contrast passing beyond T2-T3 (Fig. 2).Following all investigations, the patient underwent rigid esophagoscopy for foreign body removal and stricture dilation.Multiple pieces of chicken were extracted, and a stricture was observed.The chest X-ray obtained for preanesthesia clearance revealed a radiopaque structure resembling a chicken bone corresponding to the area of foreign body (Fig. 3).This finding had not appeared in any of the earlier investigations, which created a dilemma for us.We could not visualize any foreign body other than the pieces of chicken.To ensure accuracy, we decided to double-check using a C-arm.However, no clear radiographic evidence of a foreign body was identified in the operative field.This raised further doubts about the interpretation of the radiological findings.After rechecking with the C-arm for a radiopaque foreign body, the stricture was revisualized, and serial dilation was performed.