The students will be able to
-introduce esophageal foreign bodies and chemical burns
-signs and symptoms of esophageal foreign bodies and
-diagnostic findings of esophageal foreign bodies and
- management of esophageal foreign bodies and chemical
Many swallowed foreign bodies pass through the
GI tract without the need for medical
However ,some swallowed foreign bodies (e.g.,
dentures ,fish bones ,pins ,small batteries ,items
containing mercury or lead ) may injure the
esophagus or obstruct its lumen and must be
8. DIAGNOSTIC FINDINGS
Glucagon, because of its relaxing effect on
the esophageal muscle, may be injected IV.
A flexible endoscope and retrieval devices
(e.g ., forceps ,graspers) may be used to
remove the impacted food or object from
9. Foreign bodies
Foreign bodies such as short – blunt objects ,
Sharp – pointed objects ,
Or narcotic packets require special consideration.
10. bougienage procedure
For example , dilation techniques such as bougienage
procedure can be used to facilitate the passage of
In bougienage ,cylindrical rubber tubes of different sizes
called bougies, are advanced in to the esophagus via the
The dialator can manually advance the foreign object.
The procedure usually is performed in the endoscopy
suite or clinic by the gastroenterologist.
13. Chemical burns
Chemical burns of the esophagus occur most
often when a patient , either intentionally ( 67 %
; typically adults ) or unintentionally (33 %
typically children ) , swallows a strong acid or
base , with alkaline agents being the most
The patient is often emotionally distraught as
well as in acute physical pain.
Chemical burns of the esophagus may
also be caused by undissolved
medications in the esophagus ,or they
may also occur after swallowing a
battery , which may release a caustic
15. Acute chemical burn
An acute chemical burn of the esophagus may
Severe burns of the lips ,mouth and pharynx,
With pain on swallowing.
Breathing difficulties due to either edema of the throat
Or a collection of the mucus in the pharynx may occur.
16. Signs and symptoms
The patient ,who may be profoundly toxic ,
And in shock , is treated immediately for
17. Diagnostic findings
Esophagoscopy and barium swallow are
performed as soon as possible to determine
the extent and severity of damage .
Vomiting and gastric lavage are avoided to
prevent further exposure of the esophagus
to the caustic agent.
24. Medical management
The use of corticosteroids to reduce
inflammation and minimize subsequent
scarring and stricture formation is of
Antibiotics are prescribed if there is
The patient may require further treatment to prevent or manage
strictures of the esophagus .
Dilation of the bougienage may be sufficient , but may need to be
Progressively larger bougies are used to dilate the esophagus.
Some strictures requires rigid dilators , such as savary dilators .
These dilators are used in the same fashion as bougies but may be
more successful for opening difficult strictures.
For strictures that do not respond to either method of
dilation , surgical management may be necessary.
Reconstruction may be accomplished by esophagectomy
and colon interposition.
To replace the portion of esophagus removed.
This surgery is quite complex and should be considered
only when other options have failed.
Brunner and Suddarth’s Textbook of Medical- Surgical Nursing
,South Asian Edition , Volume 1 , Published by Wolters Kluwer .
Page reffered to 849 -854.
Ansari and Kaur, Textbook of Medical – Surgical Nursing 1 .
Published by Pee Vee 2011 Edition, Page reffered to 850 – 852.