An Unusual Cause of Dysphagia in a Mentally Retarded, Deaf and Dumb Child

We report a 7 year old mentally retarded, deaf and dumb male child presenting with history of fever, cough and swallowing difficulty for 3 days. On examination he was found to be febrile with pharyngeal congestion and mild bilateral tonsilar enlargement. A provisional diagnosis of retropharygeal abscess was made, and an X-ray soft tissue neck was asked for. Surprisingly the X-ray showed a toe ring in the hypopharynx which was removed by esophagoscopy. It is extremely difficult to diagnose foreign body as the cause of dysphagia in a deaf and dumb child, especially in a mentally retarded one. This causes delay in diagnosis and increases complications. Physicians should maintain a high index of suspicion of such a rare cause of dysphagia in the mentally challenged children.