Esophageal foreign bodies are frequently encountered in clinical practice, representing the most common site for ingested foreign bodies or food impaction within the gastrointestinal tract.
This article discusses esophageal foreign bodies; a general view of the theme is available in the main articles, ingested foreign bodies in adults and ingested foreign bodies in children.
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Epidemiology
Children are more prone to esophageal foreign bodies, often due to accidental ingestion of coins, batteries, toy parts, pins, needles, and various types of food 1-3.
In adults, foreign body ingestion can be accidental or intentional, usually occurring in patients with intellectual disability, psychiatric diseases, and drunkards 1-3. The most common cause of impaction in adults is meat, chicken and fish bones, and dentures 1,3-6.
Clinical presentation
The symptoms of esophageal foreign bodies include 1-6:
retrosternal fullness
chest pain
hypersalivation
hiccups
gagging
choking
coughing
retching
dysphagia, and odynophagia
Pathology
Foreign bodies can become impacted in various segments of the esophagus. The most common locations for impaction occur at the level of physiologic esophageal narrowing 1-3,6:
upper esophageal sphincter (UES)
aortic arch Level
lower esophageal Sphincter (LES)
Radiographic features
Plain radiograph
A chest x-ray may help identify the object and its location 2-6. Flat things like coins or disk batteries usually appear round on the frontal x-ray view 4. Bone and glass may be detectable; however, materials like food, plastic, wood, and aluminum may not be visible on x-rays 4.
CT
CT scans are highly sensitive in detecting foreign bodies and can provide valuable information about complications, such as perforation, fistula, and abscesses 1,3-6. Some calcified objects not identified on conventional radiography can be detected on CT 4.
Treatment and prognosis
Most ingested foreign bodies pass through the esophagus spontaneously within seven days; however, some cases necessitate intervention removal 1-6. Endoscopic removal is the procedure of choice 1-6. In rare situations, surgery may be necessary 3-6.
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