Ingestion & Aspiration of Foreign Bodies Flashcards
(18 cards)
Esophageal Foreign Bodies are more common in which age?
Children ≤5 years of age
Are Esophageal Foreign Bodies on purpose or accidental?
Accidental
In The United States and Europe, the most common Esophageal Foreign Body is:
Coins
In marine areas, the most common Esophageal Foreign Body is:
Fish bones
What is the narrowest portion of the GI tract?
Esophagus
What are the three main areas of narrowing in the esophagus?
1) Cricopharyngeus sling
2) Level of the aortic arch in the mid-esophagus
3) Lower esophageal sphincter (GE junction)
Sharp FBs may penetrate the mucosa at any level and cause:
1) Mediastinitis
2) Aortoenteric fistula
3) Peritonitis
How can FB ingestion present?
1) Witnessed event Or disappearance of an object
2) Asymptomatic
3) Drooling
4) Neck and throat pain
5) Dysphagia
6) Emesis
7) Wheezing, or respiratory distress
8) Abdominal pain
How can FB ingestion present on physical exam?
1) Majority are normal!!!
2) Signs of complications:
a) Oropharyngeal abrasions
b) Crepitus
c) Signs of peritonitis
What investigations should you order for Esophageal Foreign Bodies?
1) Neck and chest X-ray (AP and lateral)!
2) Contrast esophagography
3) Esophagoscopy
How do coins appear on AP X-Ray?
En face (Round/flat circle)
How do coins appear on Lateral X-Ray?
Side-on view (thin line or disc)
Most ingested coins are located in the:
Proximal esophagus
Will the majority of proximal coins pass by themselves?
No; They remain entrapped and require retrieval.
What are the options for ingested coin retrieval?
1) Endoscopy (rigid or flexible)
2) Foley balloon extraction with fluoroscopy
Are the options for coin retrieval safe?
Yes; their safety and success rate approaches 100% with minimal complications
If the ingested coin reaches the lower esophagus, what could happen?
1) Often spontaneously pass into the stomach
2) Can be observed
3) Can be advanced into the stomach (with NG Tube in ER)
