A 37-year-old incarcerated male with a history of schizophrenia presented to the emergency department with dysphagia after intentional ingestion of a metallic foreign body. Past medical history was remarkable for multiple prior procedures for removal of esophageal and gastrointestinal foreign bodies. The patient was not in distress and tolerating his secretions. Flexible laryngoscopy was unremarkable. Plain radiography was remarkable for a radiopaque metallic foreign body, consistent with the face of a combination lock, located at the thoracic inlet within the proximal esophagus (Figure 1). The patient failed flexible endoscopic removal by gastroenterology and underwent rigid esophagoscopy with removal of the esophageal foreign body in the operating room (Figure 2).

中文翻译：

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解锁吞咽困难：有意摄入异物。

一名有精神分裂症病史的 37 岁被监禁男性在故意摄入金属异物后出现吞咽困难到急诊科就诊。过去的病史对于去除食管和胃肠道异物的多次先前手术是显着的。病人没有痛苦，也能忍受他的分泌物。软式喉镜检查无异常。X 线平片显示一个不透射线的金属异物，与密码锁的表面一致，位于食管近端的胸部入口处（图 1 ））。患者肠胃软镜取出失败，在手术室接受硬质食管镜取出食管异物（图2 ））。