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Foreign Body, Esophageal, Emergency Medicine

Joanna W. Davidson Reviewed 06/2017
 


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% ...

Diagnosis

Signs and Symptoms

  • Acute ingestion:

    • Dysphagia

    • Odynophagia

    • Drooling

    • Retching/self-induced vomiting

    • Choking

    • Gagging

    • Blood-stained saliva

  • Chronically retained FB:

    • Respiratory symptoms predominate (paraes...

Treatment

Pre-Hospital

Cautions: 
  • Airway maintenance and prevention of aspiration paramount

  • Oxygen for patients in distress

  • Place patient in whatever position gives most comfort.

  • Ipecac and cathartics cont...

Follow-Up

Disposition

Admission Criteria

  • Seriously ill patients and those with complications such as esophageal perforation, migration of FB through esophageal wall, significant bleeding

  • Airway compromis...

Pearls and Pitfalls

  • Perform radiographs to locate radiopaque FBs.

  • Maintain a high suspicion for esophageal perforation.

Additional Reading

  • Cerri  RW, Liacouras  CA. Evaluation and management of foreign bodies in the upper gastrointestinal tract. Pediatr Case Rev.  2003;3:150–156.

  • Eisen  GM, Baron  TH, Dominitz  JA,...

Codes

ICD9

935.1 Foreign body in esophagus 

ICD10

  • T18.108A Unsp foreign body in esophagus causing oth injury, init

  • T18.128A Food in esophagus causing other injury, initial encounter

SNOMED

  • 47609003 foreign ...

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