Management of foreign bodies in the esophagus

Abstract

Objective: To evaluate management of foreign bodies in the upper gastrointestinal tract.

Design: Cross-sectional analytical study.

Place and duration of study: Ear, Nose, Throat Department of Mayo Hospital, Lahore, from February 1999 to December 1999.

Patients and methods: A total of 103 patients with history of foreign body ingestion were included in this study. X-ray neck and rigid oesophagoscopy was carried out in all patients for diagnosis and removal of foreign bodies. A structured questionnaire was designed to record all information.

Results: Dysphagia (92%) and tenderness in neck (60%) were the most common clinical features. Majority (89%) patients had come to the hospital within 24 hours. X-ray of the neck (lateral view) was the most useful investigation with presence of air in the esophagus being a significant finding. Post-cricoid region was the site of impaction of foreign bodies in 84% of the subjects. The procedure of esophagoscopy was successful in 90 patients (97%) and failed in 3 patients (3%). Coins were the most common foreign bodies (60%), followed by meat related foreign bodies (22.5%) and dentures in 5% cases. Complications occurred in 18% patients and were more common in adults (37.1%) compared to children (8.8%). The most serious complication was pneumomediastinum. Maximum complications occurred with dentures (80%) and bone chips (42%).

Conclusion: Foreign body in the esophagus is a serious condition and early removal by rigid esophagoscopy is recommended which is a safe and effective procedure.