This document discusses esophageal foreign bodies. It notes that children under 4 are most commonly affected, with coins and batteries being frequent objects swallowed. Diagnosis involves history, examination, and imaging like x-rays. Treatment depends on the object, with observation possible for some, while esophagoscopy is often needed for removal to prevent complications like perforation. Prompt removal of batteries is crucial due to their ability to cause chemical burns.

1. MSHANGA MJEMMAS,RESIDENT.
Dr: FILBERT MTENGA ,SPECIALIST.
ESOPHAGUS-FOREIGN BODIES

2. CONTENTS:
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 Introduction.
 Epidemiology.
 Types of FB.
 Batteries FB injury.
 Clinical symptoms.
 Diagnosis
 Investigation.
 Management.
 Complications.

3. Introduction:
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 The esophagus is the most common site of foreign
body impaction and common clinical emergencies
occurred in ENT department.
 Bones, particularly fish bones, may be swallowed
if the meat in which they are embedded is not
chewed sufficiently.

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 Infants and toddlers do not have fully mature
oropharyngeal coordination and often
inadvertently swallow small round foods which
may become impacted.
 infants and toddlers often swallow a wide variety
of inedible objects (eg, coins, batteries)
accidentally or because they are curious, and some
of these objects become impacted in the
esophagus.

5. EPIDEMIOLOGY:
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 Children more affected than adults.
 Peak incidence is in children less than 4 years of
age (up to 75%)
 More of male than females.
 No evidence of racial/geographical reported.
 Rare cases lead into death.

6. TYPES OF FB.
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 Organic materials.
 Non organic materials:- buttons, toys parts, pins and
needles, coins, batteries.
SITE OF EFB
 70% of EFB lodges at the level of the cricopharyngeus
muscles
 Other two parts includes:-
mid esophagus and gastro esophageal junction.
 Coins and smooth blunt objects are the most commonly
ingested items.

7. Continue:
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 SUMMARY:
 Cricopharyngeus muscle
(C6 level) 63%-84%
 Aortic crossover mid
esophagus 10%-17%
 Lower esophagus
sphincter 5%-20%

8. Why common in children??
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 Lack of molar teeth, poor mastication.
 Natural tendency of putting objects in mouth.
 Playing with objects inside mouth.
 Easily distractibility.
Other group who are more affected includes:
 Psychiatric patients.
 Prisoners.

9. BATTERIES UNIQUE INJURIES:
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 Ingestion of disc batteries is becoming common
because of their widespread use in hearing aids,
toys, calculators and other electronic devices.
 They contain sodium hydroxide, potassium
hydroxide and mercury which leaks through them
to cause esophageal injury.

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 It is observed that a disc battery causes damage to
mucosa in 1 h, muscle coat in 2–4 h and
perforation of the esophagus in 8–12 h, therefore it
should be removed promptly from the esophagus.

11. SIGN AND SYMPTOMS:
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 Difficulty swallowing.
 Difficulty breathing.
 Drooling of salivary.
 Poor feeding.
 Chest pain.
 Hematemesis.
 Tachycardia.

12. Diagnosis of EFB:
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 History taking and physical examination.
 Investigations.
X ray of the neck and chest AP/Lateral view.
Barium swallow:- radio lucent FB visualized(mayb use it or not)

13. Continue:
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14. Treatment:
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 Observations:- within 24hrs, child still stable.
 Balloon Catheter removal:
performed in local centers, 80% efficacy.
 Rigid esophagoscopy and foreign body removal with
forceps.
Gold standard modality.
GA needed.
With complication of orodental injury or iatrogenic perforation.

15. Complications of EFB:
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 Respiratory obstructions.
 Periesophageal cellulites or abscess.
 Esophageal perforations.
 Trachea esophageal fistula.
 Esophageal stricture.

16. Prognosis
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 80% to 90% of ingested foreign bodies will pass
spontaneously within 3 to 7 days.
 Children with esophageal injury from disc battery
need short and long-term follow-up to look for
complications related to erosion or perforation and
esophageal stricture.
 Adults with food impactions have abnormalities 85
to 90% of the time and will need evaluation and
treatment of the underlining abnormalities.

17. References:
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 Scott-Brown’s Otorhinolaryngology Head and
Neck Surgery, volume 2
 diseases of ear, nose and throat & head and neck
surgery,6th addition.
 https://canadiem.org/sirens-to-scrubs-esophageal-
foreign-body-obstructions
 https://slidetodoc.com/foreign-bodies-foreign-
bodies-foreign-body-aspiration-foreign
 Other internet sources.

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