gastrointestinal disorders
Esophageal Foreign Bodies
Introduction
Food and a variety of other swallowed objects can become impacted in the esophagus. Esophageal foreign bodies cause dysphagia and sometimes lead to perforation. Diagnosis is clinical, but imaging studies and endoscopy may be needed. Some objects pass spontaneously, but endoscopic advancement or removal is often required. (See also Overview of Foreign Bodies in the Gastrointestinal Tract .) The esophagus is the most common site of foreign body impaction. Food impactions are the most common cause of esophageal foreign bodies. Large, smooth food pieces (eg, steak, hot dogs) are particularly easy to swallow inadvertently before being chewed sufficiently. Bones, particularly fish bones, may be swallowed if the meat in which they are embedded is not chewed sufficiently. Infants and toddlers do not have fully mature oropharyngeal coordination and often inadvertently swallow small, round foods (eg, grapes, peanuts, candies), which may become impacted. In addition, infants and toddlers often swallow a wide variety of inedible objects (eg, coins, batteries) accidentally or because they are curious, and some of these objects become impacted in the esophagus. Impacted disk batteries are particularly worrisome because they may cause esophageal burns, perforation, or tracheoesophageal fistula. Foreign bodies in the esophagus usually lodge in areas where physiologic or pathologic luminal narrowing exists. Luminal narrowing may be caused by sphincters (lower esophageal sphincter, upper esophageal sphincter), external vascular structures (eg, aortic arch, aberrant subclavian artery), Esophageal Web , 