Forgein Body Injestion

Question 1

What is the most common site for foreign body impaction?

Answer 1

In the esophagus:

• Kid < 4 usually at C6
• Aortic arch T4
• Adult usually at lower esophageal sphincter T10-11

In tracheae:
Usually the Right main bronchus & Rt. Lower lobe because of the sharp angle and gravity

Question 2

What are the S&S for foreign body ingestion/ impaction?

Answer 2

In Esophagus:
1- vomiting 
2-chocking 
3-gaging 
4- throat or neck pain
5- painful or difficulty swallowing 

In Bronchus:

• Stridor
• Wheezing
• Coughing
• if late presentation; pneumonia

Question 3

What are the steps in case of suspicion of foreign body ingestion in esophagus?

Answer 3

1- detailed History indecent, pulmonary and GIT history to help locate the impaction
2- don’t forget to review other systems
3- perform airway, breathing, pulmonary examination
4- check oropharynx and palpate the abdomen
5- stabilizing: NPO/ insert IV / Attach monitor
6- do chest X-ray ( tracheal impaction may not show and need CT scan ) also fish bones usually are not visible
7- if you find the object even if it’s clear DONT forget to look around for smaller impactions, air trapping, athelectasis, or pneumothorax
8- call specialist to do Endoscopy ASAP

Question 4

What are the complications of foreign body impaction in the esophagus?

Answer 4

Perforation
Necrosis
Stricture
In rare cases: erosion into the mediastinum or great vessels