Skip to main content

Advertisement

Log in

Update on Foreign Bodies in the Esophagus: Diagnosis and Management

  • ESOPHAGUS (L GERSON, SECTION EDITOR)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Foreign body impaction in the esophagus is an important emergency that carries significant morbidity and potential mortality. The most common cause of esophageal foreign body obstruction in adults is meat bolus impaction above a pre-existing distal esophageal (mucosal) ring, peptic or malignant esophageal stricture, or eosinophilic esophagitis. Immediate evaluation of the airway, assessment of the urgency of removal, radiological evaluation to localize the object, endoscopic or surgical retrieval, and subsequent monitoring for complications are essential steps in the management.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as •• Of major importance

  1. Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995;41:39–50.

    Article  PubMed  CAS  Google Scholar 

  2. Diniz LO, Towbin AJ. Causes of esophageal food bolus impaction in the pediatric population. Dig Dis Sci. 2012;57:690–3.

    Article  PubMed  Google Scholar 

  3. Kirchner GI, Zuber-Jerger I, Endlicher E, Gelbmann C, Ott C, Ruemmele P, et al. Causes of bolus impaction in the esophagus. Surg Endosc. 2011;25(10):3170–4. Epub 2011 Apr 13.

    Article  PubMed  Google Scholar 

  4. •• Sperry SL, Crockett SD, Miller CB, Shaheen NJ, Dellon ES. Esophageal foreign-body impactions: epidemiology, time trends, and the impact of the increasing prevalence of eosinophilic esophagitis. Gastrointest Endosc. 2011;74(5):985–91. Epub 2011 Sep 1. In this study, the increasing eosinophilic esophagitis prevalence only partially explained the increased number of endoscopies performed for food impactions. However, since only a minority of patients underwent biopsies, the true incidence of eosinophilic esophagitis might have been substantially underestimated, thus emphasizing the importance of obtaining biopsies in this setting.

    Article  PubMed  Google Scholar 

  5. Li Z-S, Sun Z-X, Zou D-W, Xu G-M, Wu R-P, Liao Z. Endoscopic management of foreign bodies in the upper-GI tract: experience with 1088 cases in China. Gastrointest Endosc. 2006;64:485–92.

    Article  PubMed  Google Scholar 

  6. Larsson H, Bergquist H, Bove M. The incidence of esophageal bolus impaction: is there a seasonal variation? Otolaryngol Head Neck Surg. 2011;144(2):186–90. doi:10.1177/0194599810392655.

    Article  PubMed  Google Scholar 

  7. Harlor EJ, Lindemann TL, Kennedy TL. Outdoor grilling hazard: wire bristle esophageal foreign body-a report of six cases. Laryngoscope. 2012;122:2216–8.

    Article  PubMed  Google Scholar 

  8. •• Crockett SD, Sperry SL, Miller CB, Shaheen NJ, Dellon ES. Emergency care of esophageal foreign body impactions: timing, treatment modalities, and resource utilization. Dis Esophagus. 2012. [Epub ahead of print]. This retrospective study looked at the predictive risk factors that were associated with esophageal foreign body impactions in 316 cases. The authors determined that the risk of complications was increased with longer duration of impaction, bone type, and larger bolus size.

  9. Eisen GM, Baron TH, Dominitz JA, et al. Guideline for the management of ingested foreign bodies. Gastrointest Endosc. 2002;55:802–6.

    Article  PubMed  Google Scholar 

  10. Sung SH, Jeon SW, Son HS, Kim SK, Jung MK, Cho CM, et al. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis. 2011;43(8):632–5. Epub 2011 Apr 3.

    Article  PubMed  Google Scholar 

  11. Pinto A, Muzj C, Gagliardi N, Pinto F, Setola FR, Scaglione M, et al. Role of imaging in the assessment of impacted foreign bodies in the hypopharynx and cervical esophagus. Semin Ultrasound CT MR. 2012;33:463–70.

    Article  PubMed  Google Scholar 

  12. McNeill MB, Sperry SL, Crockett SD, Miller CB, Shaheen NJ, Dellon ES. Epidemiology and management of oesophageal coin impaction in children. Dig Liver Dis. 2012;44(6):482–6. Epub 2012 Feb 9.

    Article  PubMed  Google Scholar 

  13. •• Leopard D, Fishpool S, Winter S. The management of oesophageal soft food bolus obstruction: a systematic review. Ann R Coll Surg Engl. 2011;93(6):441–4. This systematic review of the management of esophageal soft food bolus obstructions failed to show that any medical intervention was more effective than awatch and waitapproach (spontaneous disimpaction). Surgical removal was effective and involved risk but, if done within 24 h, could prevent complications deriving from the initial obstruction.

    Article  PubMed  CAS  Google Scholar 

  14. Weant KA, Weant MP. Safety and efficacy of glucagon for the relief of acute esophageal food impaction. Am J Health Syst Pharm. 2012;69:573–7.

    Article  PubMed  CAS  Google Scholar 

  15. Desai TK, Stecevic V, Chang CH, et al. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005;61:795–801.

    Article  PubMed  Google Scholar 

  16. Chen T, Wu HF, Shi Q, Zhou PH, Chen SY, Xu MD, et al. Endoscopic management of impacted esophageal foreign bodies. Dis Esophagus. 2012 Sep 13. [Epub ahead of print].

  17. Wu WT, Chiu CT, Kuo CJ, Lin CJ, Chu YY, Tsou YK, et al. Endoscopic management of suspected esophageal foreign body in adults. Dis Esophagus. 2011;24(3):131–7. doi:10.1111/j.1442-2050.2010.01116.x. Epub 2010 Oct 13.

    Article  PubMed  CAS  Google Scholar 

  18. Bounds BC. Endoscopic Retrieval Devices. Tech Gastrointest Endosc. 2006;8:16–21.

    Article  Google Scholar 

  19. Schmidt SC, Strauch S, Rösch T, Veltzke-Schlieker W, Jonas S, Pratschke J, et al. Management of esophageal perforations. Surg Endosc. 2010;24:2809–13.

    Article  PubMed  Google Scholar 

  20. van Heel NC, Haringsma J, Spaander MC, Bruno MJ, Kuipers EJ. Short-term esophageal stenting in the management of benign perforations. Am J Gastroenterol. 2010;105:1515–20.

    Article  PubMed  Google Scholar 

  21. Vallböhmer D, Hölscher AH, Hölscher M, Bludau M, Gutschow C, Stippel D, et al. Options in the management of esophageal perforation: analysis over a 12-year period. Dis Esophagus. 2010;23:185–90.

    Article  PubMed  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to George Triadafilopoulos.

Additional information

This article is part of the Topical Collection on Esophagus

Rights and permissions

Reprints and permissions

About this article

Cite this article

Triadafilopoulos, G., Roorda, A. & Akiyama, J. Update on Foreign Bodies in the Esophagus: Diagnosis and Management. Curr Gastroenterol Rep 15, 317 (2013). https://doi.org/10.1007/s11894-013-0317-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-013-0317-5

Keywords

Navigation