Esophageal foreign bodies: types and techniques for removal

Area of Science:

• Gastroenterology
• Pediatric Gastroenterology
• Emergency Medicine

Background:

• Esophageal foreign bodies are common and can lead to severe complications if not managed promptly.
• Accurate assessment of object type, ingestion time, location, and potential complications is essential for effective treatment.

Purpose of the Study:

• To outline the diagnostic and therapeutic strategies for managing esophageal foreign bodies.
• To emphasize the importance of prompt intervention for high-risk objects and patients.

Main Methods:

• Flexible endoscopy is the primary therapeutic modality for most esophageal foreign bodies.
• Key endoscopic principles include airway protection, controlled object manipulation, and minimizing iatrogenic injury.
• Specialized devices like esophageal over-tubes and protector hoods can enhance safety during extraction of sharp objects.

Main Results:

• Button batteries and sharp objects necessitate immediate removal due to high risk of esophageal injury.
• Coins may undergo a brief observation period, particularly in the distal esophagus, as spontaneous passage can occur.
• Food impactions often indicate an underlying esophageal structural abnormality requiring further treatment.

Conclusions:

• Timely diagnosis and appropriate management, primarily flexible endoscopy, are critical for esophageal foreign bodies.
• Urgent removal is indicated for complete esophageal obstruction, sharp objects, and button batteries to prevent life-threatening complications.
• Careful endoscopic technique and adjunct devices improve safety and efficacy of foreign body extraction.