FOREIGN BODIES IN OESOPHAGUS
IS IT COMMON ?
YES ! Foreign bodies in oesophagus is very common in children and in the patients having the false teeth or loose teeth.Any type of foreign body can enter the oesophagus e.g coins,pieces of bones and ill fitted dentures.
Common sites of impaction are either at upper end just below the beginning or the middle left bronchus crosses or lower end.
Pathology changes depend upon the type of foreign body.If foreign body is sharp object,it will pierce the mucous membrane,will ulcerate the lining,and will cause localised inflammatory reaction i.e Oesophagitis leading to abscess formation.
Foreign body may pierce through and through causing the inflammation to spread outside the oesophageal wall leading to formation of abscess or inflammation to the immediate neighbourhood which may be neck or mediastinum.
Other changes may occur due to dehydration or toxaemia.
WHAT ARE THE SYMPTOMS ?
Following are the symptoms which occur due to foreign body in the oesophagus :-
1) Dysphagia which may be complete or partial.
2) Pain at the site of impaction and during swallowing.
3) Excessive salivation.
4) If foreign body is a big one ,it will press the oesophagus leading to Dyspnoea.
5) Miscellaneous symptoms due to dehydration and toxaemia.
6) There may be Fever and weakness.
WHAT ARE THE INVESTIGATIONS ?
1) Plain X-ray chest and neck ( AP and Lateral View ). Radio-opacity will be clearly visible some times an air shadow.
2) Occasionally Barium meal swallow is done.
WHAT IS THE TREATMENT ?
Endoscopic removal of foreign body is done under General Anaesthesia.
Occasionally it is necessary to open the Oesophagus by Tracheostomy and Oesophagotomy.
This major surgery is only done when endoscopic removal of foreign body is not possible. If a foreign body is a round object it can easily be pushed into the stomach.