ESOPHAGEAL IMPACTION OF FERTILIZED DUCK EGG ALBUMEN (HARDENED BALUT WHITE) IN A TERTIARY GOVERNMENT HOSPITAL IN THE PHILIPPINES: A CASE SERIES

Abstract

Background: This study described the clinical profile of patients who developed esophageal impaction after ingesting the hardened white portion (albumen) of a fertilized duck egg (colloquially termed balut). Methods: A review of patients with foreign body impaction of hardened balut egg white was performed. These patients were admitted in the emergency room from November 2013 to November 2018. Clinical features analyzed included age, sex, clinical signs and symptoms, imaging performed, operative findings and complications. Results: In all, 18 patients were included in the review. Seventeen were male with a majority in the 20- to 40-year-old age range. Dysphagia and neck tenderness were the most commonly presented symptoms and physical examination finding, respectively. Twelve cases were successfully extracted via rigid esophagoscopy under general anesthesia, while one case was resolved through spontaneous ejection. The most common site of impaction was at the cervical esophagus. One third of patients undergoing extraction had minor noncircumferential esophageal abrasions. Conclusion: Ingestion of the entire hardened balut white can lead to esophageal impaction, necessitating admission and operative management. Young males are commonly affected. Due to its intrinsic characteristics as a foreign body, its removal can prove challenging. Push technique and extraction (both via piecemeal and wholly) were found to be effective, and when performed correctly, minimized complications. Nevertheless, this condition may be prevented with health education.