Esophageal foreign body

Case contributed by Dr István Kui

Presentation

After eating a piece of bread one day earlier he could only ingest fluids.

Patient Data

Age: 9 years
Gender: Male
Barium

A 12 mm rounded, mobile filling defect is visible in the terminal esophagus in anteroposterior and lateral view on the first two images. The third and fourth image has been taken one hour after the first two in the anteroposterior view.

Case Discussion

The barium ingestion is continuous. No displacement or external compression on the esophagus can be observed; we can also see that even the stomach contains contrast material. The patient after one hour, had the same symptoms. We investigated the patient to see how the supposed obstacle was behaving. It is important to see that the radiolucency is mobile, so we do not misdiagnose with an esophageal tumor.

The patient underwent gastroscopy, where it was found a kernel of corn in the lower part of the esophagus. They have also seen cardia stricture, which was caused by inflammation.

They recommended PPI treatment for two weeks. 

The esophagus is the most common site of foreign body impaction. Usually, the large food pieces are easy to swallow inadvertently because they are not chewed sufficiently.

Infants and toddlers do not have fully mature oropharyngeal coordination.

Foreign bodies in the esophagus usually lodge in areas where physiologic or pathological luminal narrowing exists.

The luminal narrowing may be caused by sphincters, external vascular structures (aberrant subclavian artery, aortic arch), webs, rings, strictures, benign tumors, cancerous tumors, achalasia, diffuse esophageal spasm, previous surgery, eosinophilic esophagitis.

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Case information

rID: 82770
Published: 10th Oct 2020
Last edited: 11th Oct 2020
Inclusion in quiz mode: Included
Institution: Jósa András Egyetemi Oktatókórház Nyíregyháza