Foreign Bodies

1. Esophagus

• Narrowest portion of GI
• coins/fish bone (geography) < 5 years
• 3 main narrowing
  • Cricopharyngeus sling (upper esophagus)
    • Chocking (presses anteriorly on trachea)
    • Drooling
    • Pain at site
    • Asymptomatic yet witnessed
  • Level of Aortic arch (mid-esophagus)
  • GEJ

More probable if

• Eosionphlic esophagitis/strictures => narrowing
• Esophageal atresia => surgery (strictures at site of surgery)

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Sharp FB

• Mediastinitis
• Peritonitis (lower ESOPHAGUS)

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Management

Usually stable (non drowsy/shocked)

• regular Hx & PEx
  • Sxs vary based on site
  • PEx most cases: Normal
    • Oropharyngeal abrasions
    • Crepitus/wheezes
    • Peritonitis

1. If FB in the pharynx, use forceps take it out and discharge from ERX-ray in
2. If not found => neck & chest Xray (AP&Lat)

+- contrast esophagography (chicken appears as filling defect)