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Site Of Lodgement
Category: FOREIGN BODIES IN THE ESOPHAGUS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Almost all foreign bodies are arrested in the
cervical esophagus at the level of the superior aperture of the
thorax. A physiologic narrowing is present at this level, produced in
part by muscular contraction, and mainly by the crowding of the
adjacent viscera into the fixed and narrow upper thoracic aperture. If
dislodged from this position the foreign body usually passes downward
to be arrested at the next narrowing or to pass into the stomach. The
esophagoscopist who encounters the difficulty of introduction at the
cricopharyngeal fold expects to find the foreign body above the fold.
Such, however, is almost never the case. The cricopharyngeus muscle
functionates in starting the foreign body downward as if it were food;
but the narrowing at the upper thoracic aperture arrests it because
the esophageal peristaltic musculature is feeble as compared to the
powerful inferior constrictor.