Foreign Body, Esophageal

Basics

Description

  • Esophageal foreign bodies (FBs) typically lodge at 3 sites of physiologic or pathologic constriction:
    • Upper esophageal sphincter
    • Level of the aortic arch
    • Diaphragmatic hiatus
  • 80–90% of ingested FBs pass spontaneously
  • 10–20% are removed endoscopically
  • 1% or less require surgery

Etiology

  • Most common adult and adolescent FBs are food boluses
  • Increased risk:
    • Older adults and individuals with underlying psychiatric disease or intoxication
    • Structural or functional esophageal abnormalities: webs, rings, strictures, tumors, achalasia:
      • Up to 50% of patients with food impactions have underlying eosinophilic esophagitis (EoE)

Pediatric Considerations

  • Majority of FB ingestions occur ages 6 mo–3 yr
  • Common FBs:
    • Most are coins
    • Button battery ingestions increasing due to expanded use in household objects
    • Sharp objects (needles, pins, nails, bones) account for 10–15%
    • Magnets (including high-powered magnets) increasing:
      • Serious complications if multiple ingested
    • Superabsorbent polymers:
      • Increasing risk of obstruction

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