Esophageal Foreign Body

Sources: A Manual Of Peroral Endoscopy And Laryngeal Surgery

After initial choking and gagging, or

without these, there may be a subjective sense of a foreign body,

constant or, more often, on swallowing. Odynphagia and dysphagia or

aphagia may or may not be present. Pain, sub-sternal or extending to

the back is sometimes present. Hematemesis and fever may occur from

the foreign body or from rough instrumentation. Symptoms referable to

the air-passages may be present due to: (1) Overflow of the secretions

on attempts to swallow through the obstructed esophagus; (2) erosion

of the foreign body through from the esophagus into the trachea; or

(3) trauma inflicted on the larynx during attempts at removal, digital

or instrumental, the foreign body still being present or not.

Diagnosis is by the roentgenray, first without, then, if necessary,

with a capsule filled with an opaque mixture. Flat objects, like

coins, always lie with their greatest diameter in the coronal plane of

the body, when in the esophagus; in the sagittal plane, when in the

trachea or larynx. Lateral, anteroposterior, and sometimes also

quartering roentgenograms are necessary. One taken laterally, low down

on the neck but clear of the shoulder, will often show a bone or other

semiopaque object invisible in the anteroposterior exposure.