Foreign Body, Esophageal

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Basics

Description

  • Esophageal foreign bodies (FBs) typically lodge at 3 sites of physiologic constriction:
    • Cricopharyngeal muscle – 63%, most common (C6)
    • Gastroesophageal junction – 20% (T11)
    • Aortic arch – 10% (T4)
  • 90% of ingested FBs pass spontaneously
  • 10–20% are removed endoscopically, and 1% or less require surgery

Etiology

  • Most common adult and adolescent FBs are food boluses and bones
  • Increased risk:
    • Edentulous adults
    • Intoxicated patients
    • Patients with underlying esophageal disease: Schatzki B-rings or peptic strictures are most common

Pediatric Considerations
  • 80% of FB ingestions occur in pediatric age group, peak ages 6 mo–6 yr, particularly younger than 2 yr
  • Coins are most common:
    • 80% of esophageal FBs
  • 2 additional areas of constriction: Thoracic inlet (T1) and tracheal bifurcation (T6)

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Basics

Description

  • Esophageal foreign bodies (FBs) typically lodge at 3 sites of physiologic constriction:
    • Cricopharyngeal muscle – 63%, most common (C6)
    • Gastroesophageal junction – 20% (T11)
    • Aortic arch – 10% (T4)
  • 90% of ingested FBs pass spontaneously
  • 10–20% are removed endoscopically, and 1% or less require surgery

Etiology

  • Most common adult and adolescent FBs are food boluses and bones
  • Increased risk:
    • Edentulous adults
    • Intoxicated patients
    • Patients with underlying esophageal disease: Schatzki B-rings or peptic strictures are most common

Pediatric Considerations
  • 80% of FB ingestions occur in pediatric age group, peak ages 6 mo–6 yr, particularly younger than 2 yr
  • Coins are most common:
    • 80% of esophageal FBs
  • 2 additional areas of constriction: Thoracic inlet (T1) and tracheal bifurcation (T6)

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