2. • Fibromuscular tube
• 25cm,from C6 to T11
• a) mucosa
• b) submucosa
• c) musular layer
• d) fibrous
3. • Nerve supply
• Parasympathetic from vagus and
• Sympathetic from the trunk.
• Lymphatic Drainage-
• cervical into deep cervical nodes
• thoracic into posterior mediastinal
• abdominal into gastric nodes.
4. Applied anatomy
• 1. at pharyngo-oesophageal junction(C6)-
15cm from upper incisors.
• 2. at the crossing of arch of aorta and left
main bronhus(T4)-25cm from the upper
incisors.
• 3. as it pierces the diaphragm(T10)-40 cm
from upper incisors.
5. Foreign bodies in food passage
• Commonly ingested F B –
• fish bone,
• chicken bone,
• needle,
• denture,
• coin or
• safety pin.
6. Aetiology
• AGE
• Loss of protective mechanism-dentuers
• unconsciousness
• epileptic seizures
• alcoholic intoxication
• Narrowed passage-stricture or CA
• psychotics
7. Clinical features
• History of choking or gagging
• Discomfort
• Dysphagia
• Drooling of saliva
• Respiratory distresss
• Substernal or epigastric pain due to spasm
• Tenderness
• Pooling in pyriform fossa
8. management
• Plain X-rays- PA of neck and lateral view
• Children screened from nasopharynx to
rectum for multiple foreign bodies
• Fluroscopy for radiolucent foreign bodies
• Oesophagoscopic removal
9. Indications
• Dignostic-
• cause of dysphagia as CA achalasia cardia
stricture or diverticula
• Cause of retrosternal burning as hiatus hernia
or reflux oesophagitis
• Cause of haemetmesis-oesophageal varices
• As a part of panendoscopy- to know the
primary
10. Therapeutic
• Removal of foreign body
• Dilatation of strictures
• Removal of benign lesions as cyst or fibroma
• Injection of varices
• Insertion of tube for palliative treatment of CA
11. contraindications
• Trismus
• Diseases of cervical spinesas spondylosis
tuberculous spine, kyphosis
• Receding mandible
• Aneurism of aorta
• Advanced heart, liver or kidney diseases.
12. Steps for procedure
• Identification of arytenoids
• Passing cricopharyngeal sphincter
• Crossing the aortic arch and left main
bronchus
• Passing the cardia
13. complications
• Injury to lips and teeth
• Injury to arytenoids
• Injury to pharynx
• Perforation of oesophagus-at the Killians
dehiscence-pain in interscapular region,raised
temperature, surgical emphysema may
develpe, may get complicated by abscess in
retropharyngeal space or mediastinum.
