Naples – He presented himself to the emergency room at Vecchio Pellegrini with severe chest pain, believing he had a heart problem. But doctors, after routine tests, made a disconcerting discovery: a metal bottle cap lodged in his esophagus.
A rare and dangerous case, resolved thanks to emergency intervention by doctors at the ASL Napoli 1 Centro hospital.
The unexpected discovery
The patient—a man in his 40s—had gone to the emergency room complaining of persistent retrosternal pain, unrelated to physical exertion or difficulty breathing. The symptoms reportedly suggested a heart condition.
An electrocardiogram and cardiac enzyme analysis were performed immediately, both of which were negative, thus ruling out an ischemic origin of the pain.
Despite the reassuring results, the emergency room doctors, coordinated by Dr. Emilio Bellinfante, decided to further investigate with a chest X-ray, also in light of the persistent foreign body sensation and pain when swallowing reported by the patient.
The X-ray revealed the unthinkable: a rounded, radiopaque shadow in the middle of the esophagus. What appeared to be a heart problem was actually a metal bottle cap with a crown rim, stuck there for days.
The emergency intervention
The man was immediately transferred to the Complex Surgery Unit directed by Professor Alberto D'Agostino, where he underwent urgent esophagogastroduodenoscopy under deep sedation, with intubation in the operating room.
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The surgery was performed by Dr. Vittorio D'Onofrio, head of the Gastroenterology and Endoscopy Unit at Pellegrini Hospital, with the assistance of nurses Rosaria and Silvana Sarnelli and the entire surgical team.
During endoscopy, the plug was located 28 centimeters from the incisors, surrounded by edema and signs of mucosal ulceration.
By using a rat-tooth forceps and a protective cap mounted on the endoscope, the doctors were able to remove the foreign body in a single maneuver, without causing damage to the esophageal wall.
After the procedure, the man – who did not remember accidentally swallowing the cork – was kept under observation for a few hours and discharged that evening, with complete resolution of symptoms and no complications.
"Thanks to the multidisciplinary approach and the prompt intervention," stated Dr. Maria Corvino, medical director of the Pellegrini Hospital, "the patient was able to leave the hospital without any serious consequences. This experience demonstrates the importance of collaboration between departments and the prompt diagnosis of healthcare personnel."
A rare but not isolated case
According to specialists, esophageal foreign bodies represent one of the most insidious emergencies in gastroenterology: they often manifest with atypical chest pain, easily confused with heart disease.
In Italy, every year, approximately 1.500 people are hospitalized for accidentally ingesting metal or plastic objects, especially bottle caps, coins, or dentures.
The Vecchio Pellegrini case—with its combination of diagnostic insight and immediate intervention—adds to the growing list of clinical success stories that demonstrate the high level of expertise at the Neapolitan hospital, which has always been a point of reference for emergencies in the historic center.
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