This document provides tips for using a PowerPoint presentation on foreign bodies in the esophagus. It recommends: - Editing, modifying, and adding your name to freely downloaded slides. - Not worrying about number of slides, as half are blank except for titles to facilitate active learning sessions. - Showing blank slides, asking students what they know, then showing slides with content. - Rerunning the show at the end to reinforce learning. - Using this approach for self-study as well. - Checking notes for bibliography citations.

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.

2. Learning Objectives

3. Learning Objectives
1. Introduction & History
2. Relevant Anatomy, Physiology
3. Aetiology
4. Pathophysiology
5. Pathology
6. Classification
7. Clinical Features
8. Investigations
9. Management
10. Prevention
11. Guidelines
12. Take home messages

4. Introduction & History.
•

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.

6. Aetiology

7. Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative / lifestyle
• Iatrogenic
• Psychosomatic
• Poisoning/ Toxins/ Drug induced

8. Etiology
• Idiopathic
• Congenital
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative

9. Pathophysiology

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.

14. Clinical Features
•

15. Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications

16. Demography

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.

20. Symptoms
• .

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.

24. Signs

25. Signs
• None
• Rarely signs of infections:
– Mediastinitis
– Pyothorax
– Peritonitis

26. Complications

27. Complications
• Pressure necrosis,
• fistula,perforation
• infection,
• obstruction.
• Button batteries can rapidly create
– esophageal necrosis.
– oesophageal strictures

28. Complications
• Mucosal scratches or abrasions, punctures,
and perforations
– Abscesses
– Pneumomediastinum,mediastinitis
– pericarditis/tamponade
– Pneumothorax,pneumomediastinumt
– racheoesophageal fistula
– vascular injuries to
• aorta (aortoesophageal fistulas)
• pulmonary vasculature.

29. Investigations

30. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology
– Germ line Testing and Molecular Analysis
• Diagnostic Laparotomy.

31. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histlogy

32. Diagnostic Studies

33. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan

34. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan
• Metal detectors

38. Management
•

39. Management
• Observation
• Endoscopy
• Foley catheter removal
• Magill forceps removal of esophageal
foreign bodies
• Bougienage

40. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

41. Get this ppt in mobile

42. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
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• https://www.facebook.com/doctorpradeeppa
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