Foreign bodies in the esophagus – symptoms, diagnosis, treatment, prevention

Proven content

Foreign bodies in the esophagus are more common in children who accidentally swallow coins, small toys, or parts of them. Adults, on the other hand, swallow poorly fixed dentures, bones or objects that have accidentally entered the food while eating quickly.

Foreign bodies in the esophagus

A foreign body in the esophagus is an object that has stuck to the walls of the esophagus after it has entered the esophagus or is unable to pass further due to its large size. Objects usually end up in the esophagus by accident, most often this problem occurs in children who accidentally swallow pieces of toys or other objects. The relatively large dimensions of the pharynx mean that foreign bodies are rarely caught in them, and if it does, it is because they are stuck into the mucosa. In addition to children, this problem may affect the elderly, who may suffer from dysphagia for various reasons, lack teeth or undergo surgery in the larynx and pharynx area. A large group of patients diagnosed with foreign bodies in the esophagus are the mentally ill, alcoholics and prisoners. Objects most often stop in the physiological narrowing of the esophagus. A large proportion of items pass through the digestive tract without showing any symptoms.

Symptoms of a foreign body in the esophagus

Symptoms of a foreign body in the esophagus include difficulty swallowing. If the foreign body stays there longer, a reaction develops on the esophageal walls in the form of edema and later inflammation. Occasionally, the esophageal wall may be punctured with life-threatening consequences. The symptoms depend to a large extent on the level at which the foreign body has stopped. In addition to the symptoms listed, the following may appear:

1. inability to swallow,
2. salivation,
3. nausea,
4. vomiting,
5. pain at the site of a foreign body,
6. coughing attack (especially when a large object blocks the lumen of the esophagus).

If a large body remains in the esophagus, it can put pressure on the larynx and thus cause breathing problems. Foreign bodies in the esophagus also cause complications, the most dangerous of which is the perforation of the esophageal wall. Cervical perforation it causes pain, inflammatory infiltration on the neck and subcutaneous emphysema on the neck. Whereas perforation at the level of the second esophageal stricture it causes severe pain in the chest which becomes worse especially when swallowing or breathing. Dyspnea, tachycardia and pneumothorax also appear. Additionally, in both cases, hemoptysis is observed in patients.

There are cases when the presence of a foreign body in the esophagus does not cause any discomfort, therefore a thorough diagnosis is necessary.

Foreign bodies in the esophagus – diagnosis

Diagnostics includes, first of all, a thorough medical interview with the patient. In addition, it is necessary to carry out ENT examination and other additional tests. It is important to examine the tonsils, pear-shaped recesses and the base of the tongue. During the ENT examination, the doctor finds saliva in the lower throat. Upon suspicion of the presence of a foreign body, a decision is made to execute chest X-ray examinationswhich also covers the neck and epigastric region. Thanks to X-ray, it is possible to visualize the presence of a foreign body in the esophagus and possible perforation of the esophageal wall. After eliminating the perforation of the esophageal wall, it is necessary to perform radiographic examination of the esophagus with bariteusually performed with an aqueous contrast medium. Complementary is recommended in patients with negative or negative radiological examination endoscopic examination of the esophagus or computed tomography. Thanks to tomography, it is possible to more accurately assess the location of the residual object and adjacent structures and soft tissues.

How to treat foreign bodies in the esophagus?

In any case, the foreign body should be removed from the esophagus. For an object to stick into the tonsil or the root of the tongue, it is only necessary to use forceps.

Treatment of people with a foreign body in the esophagus should be started as soon as possible, because the longer the object remains in the esophagus, the greater the risk of complications. It is most often used in treatment direct visualization of the lumen of the esophagus using a rigid or flexible endnoscope. However, before the appropriate therapy is implemented, it is necessary to take into account: the patient’s age, the location of the foreign body as well as its size and shape.

The physician performing endoscopic removal of a foreign body from the esophagus should be experienced. In each case of endoscopic removal, before the procedure, the esophagus walls should be assessed for damage, as well as for possible pathological changes, such as: inflammation, scarring or the presence of neoplasm. To assess whether the esophagus has perforated during exophagoscopy, a check-up chest X-ray is performed approximately 2 hours after the operation.

Complications of the endoscopic method:

1. bleeding,
2. perforation of the esophagus wall and its consequences: mediastinitis and oesophageal-aortic fistulas; esophageal-tracheal and esophageal-bronchial.

Attention! Home attempts to remove a foreign body from the esophagus are usually unsuccessful.

Summation

1. Foreign bodies most often stay around the mouth of the esophagus (almost 35% of cases).

2. The endoscopic method of foreign body removal is the most common and surest method of treatment.

3. The most common foreign body in the esophagus is the food billet.

4. A foreign body in the esophagus always leaves behind (small or large) lesions visible on the mucosa.

Foreign body in the esophagus – prevention

In order to prevent a foreign body from remaining in the esophagus of children, parents should take care of them. Very often, a moment of inattention is enough for an unpleasant incident to occur. In addition, during physical activity, you should not hold sharp objects in your mouth. Store corrosive chemicals out of the reach of children. Finally, remember to properly prepare your meals, especially fish whose bones can get trapped in our esophagus.