Patients with a suspected foreign body in the esophagus should be treated as soon as possible. In addition to complications such as tracheoesophageal fistula, esophageal perforation, and aspiration after removal of foreign body, especially accompanying long-term obstruction, toxic materials such as batteries must be removed quickly [4]

In the literature, there is no case of isolated apnea without respiratory symptoms due to a foreign body in the esophagus.

In a case report, it was reported that a foreign body was seen in the esophagus on neck imaging in a blind, deaf, and non-speaking patient with the diagnosis of Sturge Weber’s syndrome, and the apnea–hypopnea index decreased significantly after removal [5]. In addition, it is stated that gastroesophageal reflux disease may be effective in sudden respiratory distress and sudden infant death with similar mechanisms [6].

Larynx plays an important role in ensuring the safety of the airway. It is thought to provide this effect with the laryngeal chemoreflex. With the stimulation of the mucosal receptors, a signal is sent to the brain as a reflex, and accordingly, laryngeal obstruction can be achieved [7]. In addition, the vagus nerve advances anatomically adjacent to the cervical esophagus, and it has been reported in the literature that vagal stimulation may cause additional findings such as neck pain, cough, dysphonia, paresthesia, as well as bradycardia and hypotension [8]. In our case, bradycardia and hypotension were not observed during and before the apnea periods. Additionally, the absence of additional respiratory symptoms (stridor, wheezing) did not indicate direct pressure on the trachea. However, it is thought that compressions in this location, including vagus/superior laryngeal nerve compression, may be caused by laryngeal chemoreceptor activation and related causes. Apnea monitoring, especially in the supine position, also supported positional nerve compression.

As a result, since apnea periods, which disappear with painful stimuli while awake, are not seen in the literature due to a foreign body in the esophagus; Although we could not fully explain its etiology, we wanted to share it as an experience and to share that foreign bodies that are seen safely can also be life-threatening in the acute period.