Gastrointestinal Radiology > Procedures > Foreign Bodies > Foreign Bodies (2)


Treatment of Food Impactions And Foreign Bodies in the Esophagus

Overview

  • If the patient has no respiratory distress and can manage his oral secretions, emergency removal of the foreign body may not be necessary.
      

  • If the foreign body has smooth surfaces and is nontoxic, delaying extraction may be justified, because most blunt objects will pass spontaneously through the GI tract without incident. 
     

  • However, sharp-edged or pointed foreign bodies and disk batteries, which may leak caustic material, should be removed promptly because of their potential for esophageal injury and perforation.  

  • In any case, no foreign body should be allowed to remain in the esophagus for more than 24 hours, as the incidence of complications begins to rise. 

  • The classic approach to management is esophagoscopy with forceps or snare removal of the foreign body.  Endoscopy is the method most widely advocated for removal of sharp objects. 

  • The benefits of endoscopy include:

    • the ability to visualize the foreign body during its capture and removal, 

    • to protect the airway, 

    • to evaluate the esophagus for injury and underlying pathology.  

  • The disadvantages of endoscopy include:

    • its high cost; 

    • the frequent need for general anesthesia, especially in children; 

    • the risk of esophageal perforation when the extraction instrument is passed around the foreign body where the endoscopist cannot visually control its tip.  

  • In experienced hands, endoscopy has a reported success rate of at least 90% and a complication rate of 1-13%.

 


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