Management of Esophageal Foreign Bodies: a Report on 26 Patients and Literature Review

Abstract

The purpose of this study is to present our experience of the removal of esophageal foreign bodies in children and adults using rigid esophagoscope under general anesthesia. A total of 26 patients with a history of ingested foreign body in the esophagus were admitted and treated in our hospital between July 2005 and August 2007, of whom 20 children and 6 adults. There were 14 male and 12 female patients between 6 months and 70 years of age. All patients except one had a clear history and symptoms of foreign body ingestion. The main symptoms were difficulty in swallowing, acute onset of pain, dysphagia, choking and excessive salivation. A lateral neck plain radiograph and a posteroanterior view that included the oropharynx, neck, chest, and abdomen were made routinely before esophagoscopic examination. Foreign bodies were most commonly identified in the cervical esophagus, usually immediately below the cricopharyngeus (16 children). Remaining foreign bodies were as follows: 6 (4 children, 2 adults) foreign bodies were lodged in the midesophagus and 4 (all adults) in the distal esophagus. All foreign bodies were removed under general anesthesia. A rigid esophagoscope was used to remove them. Coins were the most common foreign body removed from the esophagus, occurring in 14 patients, all children. Other foreign bodies were bones mixed with pieces of meat, button battery, staples, safety pins, chicken bones, and fish bone. There were no deaths, no perforations, no cases of mediastinitis, and actually no complications secondary to insertion of the esophagoscope and removal of the foreign body. Rigid esophagoscopy remains as safe method of esophageal foreign body removal. The timely diagnosis and endoscopic removal should be performed to prevent serious life-threatening complications.