1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.
5. Introduction & History.
• Foreign bodies in the oesophagus are
usually swallowed, purposefully or
accidentally
• The presentation is usually straightforward
but on occasion can be extremely subtle.
10. Pathophysiology
• The esophagus is a tubular structure
approximately 20-25 cm in length.
• Patients can usually localize foreign bodies
in the upper esophagus but localize them
poorly in the lower two thirds of the
structure.
11. Pathophysiology
• 3 areas of narrowing :
– the upper esophageal sphincter (UES),
– crossover of the aorta;
– lower esophageal sphincter (LES).
• Structural abnormalities of the esophagus
• strictures
• webs
• Diverticula
• Malignancies
• motor disturbances such as scleroderma,
diffuse esophageal spasm, or achalasia.
12. Pathophysiology
• Swallowed magnets from toys and
household items have become a serious
health hazard in children.
• food boluses
• coins or marbles
• toothpicks and dentures.
13. Pathophysiology
• Drug smugglers may swallow multiple
condoms (usually double wrapped) filled
with cocaine or heroin. This is called "body
packing," as opposed to "stuffing," which
occurs when the patient attempts to elude
arrest by swallowing packets of drugs in
their possession.
17. Demography
• The site of entrapment
– 75% of children having entrapment at the upper
esophageal sphincter (UES)
– 70% of adults having entrapment at the lower
esophageal sphincter (LES).
18. Demography
• The site of entrapment
– 75% of children having entrapment at the upper
esophageal sphincter (UES)
– 70% of adults having entrapment at the lower
esophageal sphincter (LES).
19. Demography
• Incidence of intentionally swallowed
foreign bodies is much higher in men than
in women.
21. Symptoms:Adults
• History of ingestion
• Foreign body sensation or vague discomfort
in the epigastrium
• Dysphagia
• Inability to handle secretions
22. Symptoms:Child
• Asymptomatic
• History has seen the child with an object in
his or her mouth and suspects the child
might have swallowed it.
• Gagging, vomiting, and neck or throat pain.
23. Symptoms:Chronic
• Poor feeding
• Irritability
• Failure to thrive
• Fever
• Stridor
• Pulmonary symptoms, such as repetitive
pneumonias from aspiration
• Large ones ar the UES can cause tracheal
impingement in children, with resultant
stridor or respiratory compromise.
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