Foreign Bodies In The Esophagus

Food and a variety of other swallowed objects can become trapped in the esophagus. Esophageal foreign body causing dysphagia and sometimes lead to a perforation. The diagnosis is made clinically, but imaging and endoscopy may be required. Some objects happen spontaneously, but often an endoscopic removal is required.

Food and a variety of other swallowed objects can become trapped in the esophagus. Esophageal foreign body causing dysphagia and sometimes lead to a perforation. The diagnosis is made clinically, but imaging and endoscopy may be required. Some objects happen spontaneously, but often an endoscopic removal is required.

(See also foreign body in the gastrointestinal tract at a glance.) Dishes and a variety of other swallowed objects can become trapped in the esophagus. Esophageal foreign body causing dysphagia and sometimes lead to a perforation. The diagnosis is made clinically, but imaging and endoscopy may be required. Some objects happen spontaneously, but often an endoscopic removal is required. Most jamming of foreign bodies are found in the esophagus. Food impactions cause most foreign bodies in the esophagus. Large, smooth pieces of food (eg. As steak, hot dogs) are especially easily swallowed accidentally before they are adequately chewed. Bone, especially bone can be swallowed if the meat in which they are embedded is not sufficiently chewed. Infants and young children do not have fully developed oropharyngeal coordination and often swallow accidentally small, round foods (such. As grapes, peanuts, candy), can have an impact. In addition, infants and young children often swallow a variety of inedible objects (eg. As coins, batteries), some of which are pinched into the esophagus. Damaged batteries are of particular concern because they can cause burns, perforation or tracheoesophageal fistula in the esophagus. Foreign body in the esophagus are usually in areas where physiological or pathological luminal narrowing is. A luminal narrowing can through tissue, rings, strictures, benign and cancerous tumors, achalasia, and caused eosinophilic esophagitis. Complications The main complications of esophageal foreign bodies Lock perforation The obstruction can be partial (z. B. swallow patient fluids or at least her own mouth secretions) or completely. A partial obstruction is less problematic, unless a sharp object is embedded in the wall, which can lead to a perforation. A complete obstruction is clinically poorly tolerated and even a smooth object when it is pressed tightly together, can lead to pressure necrosis and the risk of perforation, if it remains more than about 24 hours in the esophagus. Complications also depend on the nature of the object involved. Despite their small size, are disc or button batteries objects of particular importance because rapidly liquefied necrosis and perforation may occur. Symptoms and complaints The main symptom is acute dysphagia. Patients with obstruction of the esophagus have an increased salivation and are not to swallow oral secretions in the situation. Other symptoms include retrosternales bloating, belching, odynophagia, blood-stained saliva and retching. Hyperventilation due to anxiety and discomfort is often seen by the appearance of shortness of breath, but real dyspnea or ausculatory findings of stridor or wheezing suggest that the foreign body is more in the airways rather than the esophagus. Sometimes the debris dig along only on the esophageal mucosa and do not get caught. In these cases, the patient may complain of a foreign body sensation, although no foreign bodies are seen. Diagnosis Clinical Investigation Occasionally Often imaging endoscopic assessment Many patients have a clear history of taking on; among those with significant symptoms that indicate a complete obstruction, an immediate therapeutic endoscopy should be performed. Patients with minimal symptoms who are able to swallow normally, may not have impacted foreign bodies and can be watched at home on the resolution of symptoms. In other cases, imaging tests are necessary. Some patients, such as young children, mentally disabled adults and people with mental illness are not able to make appropriate information on history of recording these patients can present with: choking, food refusal, vomiting, drooling, wheezing, bloodstained saliva or respiratory distress. Imaging studies may be necessary in these patients. Some foreign objects can be detected with simple X-rays (preferably 2 views). These X-rays are best for detecting metallic foreign bodies and steak bones as well as for evidence of perforation (z. B. free air in the mediastinum or peritoneum). However, it can be difficult to identify fish bones and even some chicken bones, wood, plastic, glass and thin metal objects on plain radiographs. If any suspicion of a sharp or dangerous foreign bodies in the esophagus is, imaging techniques such as CT, to identify the foreign body. However, an endoscopic examination in patients with suspected foreign body intake and current symptoms is needed despite negative imaging results. A contrast study should not be because of the risk of aspiration and concern about the presence of residual contrast agent that makes the subsequent endoscopic recovery more difficult, carried out normally. Sometimes treatment process monitoring and / or i. v. Glucagon Often endoscopic resection Some foreign bodies pass spontaneously into the stomach, after they are completely gone, as a rule through the GI tract and were ejected. Patients without symptoms of severe obstruction and without recording of sharp objects or plates or button batteries can be observed h generally safe for up to 24 to await the passage that is indicated by relief of symptoms. The administration of glucagon 1 mg i.v. is a relatively safe and acceptable option, which sometimes allows the spontaneous passage of a bolus by the distal esophagus is relaxed. Other methods, such as foaming agents, plasticizers and bougienage are not recommended. Foreign bodies within 24 h do not pass (1) should be removed, since a delay reduces the risk of complications, including perforation, and increased the probability of successful removal. The endoscopic removal is the treatment of choice. The distance is best done using pliers, a basket or a sling, preferably with an overtube in the esophagus or orotracheal intubation to prevent aspiration and to protect the respiratory tract. An emergency endoscopy is necessary for sharp objects, disc or button batteries and at each installation, which causes severe symptoms. Follow-up care for assessment of structural and functional abnormalities is recommended for patients with trapped food particles in the esophagus. Treatment Notes 1. ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, Anderson MA, et al: Management of ingested foreign bodies and food impactions. Gastrointest Endosc 73: 1085-1091, 2011. doi: 10.1016 / j.gie.2010.11.010. Important Points Most strangulation due to captured foreign objects are found in the esophagus. The main symptom is acute dysphagia; Patients with obstruction of the esophagus have an increased salivation and are not to swallow oral secretions in the situation. A complete obstruction can result in pressure necrosis and increases the risk of perforation, if it consists of more than about 24 hours. An emergency endoscopy is necessary for sharp objects, disc or button batteries and at each installation, which causes severe symptoms.

Health Life Media Team

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