Site Of Lodgement

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.

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