Foreign bodies of the esophagus - deliberately or accidentally swallowed objects, pieces of food that are stuck in the lumen of the digestive tube.
Often contributes to the development of such a problem lack of teeth or wearing dentures that close the hard palate. Because of this, sensitive control over what gets into the mouth is lost. Sometimes the cause of their loss becomes intoxication, as a result of which the reflexes decrease.
The concept of
Foreign bodies fall in most situations with food. These can be large pieces of meat, bones or fish scales. Rarely are items or elements of games. Of inedible objects in the lumen of the esophagus, prostheses swallowed during sleep or eating are more often found.
In older people, the musculature of the organ is often weakened, so the objects in the thoracic area are more likely to get stuck. With burns or tumor processes, small items can linger in any department.
Reasons for the occurrence of
Various circumstances can cause the pathology:
- conversation during meals,
- poor chewing of products,
Note that ¾ of all patients with this pathology are over 40 years of age.
They are caused by improper use of prostheses. In any case, foreign bodies enter not only through the oral cavity, but also from the gastrointestinal tract, when there is regurgitation of the gastric contents, as well as crawling of the worms.
The reasons are also the peculiarities of children's behavior, namely their tendency to take small things in their mouths. In children, the dental apparatus is not yet well-founded, and the larynx has a sufficiently high location. Therefore, it is easier for children to swallow a foreign object.
Sometimes the cause of the hit is suddenly a deep breath that draws into itself a small object.
Foreign bodies are very diverse. Children in 78% of cases are more likely to get organic foreign bodies, for example, plant seeds. This type is the most dangerous, because it is associated with the appearance of complications. They can swell, crumble when removed, decompose.
If a foreign body enters the esophagus, the symptoms may appear local and common. It depends on the size, shape, place and amount of time, while in the body is the object.
The very first symptom in most cases is pain and a feeling of squeezing in the throat. The appearance of the inability to swallow speaks of a partial or complete overlap of the lumen of the esophagus.
This results in:
- regurgitation of fluid and food,
- blueing of the skin.
When squeezing the larynx, the voice becomes husky, there are signs of suffocation. There may appear a respiratory syndrome, manifested in coughing, shortness of breath or false croup. Patients with this problem are trying to unconsciously find the correct position of the head and fix it. A sign is the opening of the mouth.
The specificity of the appearance of the attributes depends on:
- the presence of sharp edges,
- by the location of the foreign body.
Sometimes the patient simply starts complaining that the food has gone worse through the esophagus.
Symptoms of a foreign body in the esophagus in a child
The incidence of the problem in children is associated with morphofunctional features.
When swallowed pointed objects, children cry violently, their saliva is abundantly separated, head movement is practically not realized.
Often kids start to refuse food. With smooth objects, the condition can be satisfactory. They drink well, but refuse to eat. There is a cough. Pain can build up or immediately be of great strength.
A contrasting foreign object can be detected by radiography. It is advisable to carry out it in two projections with the obligatory study of the neck.
Additionally, a barium study is shown that helps detect suspected obstruction.
An x-ray of the abdominal cavity should also be made. This must be done in order to determine whether a foreign body or part of it has passed into the stomach.
Esophagoscopy is also performed. For this method, an optical instrument is used, which is introduced through the mouth. The treatment procedure can be performed both for extracting foreign objects and for stopping the bleeding caused by such a problem.
In adults and children, the procedure is performed using wide tubes. The most important moment is the insertion of the tube into the initial section of the esophagus. In this case, it is important not to slip past the foreign body.
In addition, the methods of differential diagnosis, which allow to separate a foreign body in the esophagus from acute esophagitis, esophagus, ulcers of the esophagus and other diseases, in which there is paralysis of the musculature of the pharynx.
Emergency assistance with foreign esophagus body
Foreign body in the esophagus requires urgent measures. In a hospital, the removal of the object occurs using a surgical or endoscopic method.
The method is determined depending on the characteristics of the swallowed object, as well as the specificity of its adherence to the walls.
Sometimes prescribed additionally:
- enveloping anesthetics,
- solution of furacilin.
Small coins stuck in the primary esophagus in children are removed using a special spatula or laryngeal corncanga. If such removal did not bring results, but caused bleeding, it is better to interrupt the intervention and postpone it for a while.
Sometimes, when a foreign body enters, there is no dangerous situation, mainly when the object hits the trachea. Then there is no need for immediate removal of foreign matter.
Thus, patients who have a foreign body in the esophagus should be immediately taken to a specialized medical institution to clarify the diagnosis. To suppress vomiting before transportation, injections with medications are put.
This can be a solution stocked up or chlorpromazine. When swallowing a needle or a pin, as well as small objects, permanent supervision is assigned, since in most cases such objects go out on their own.
Indications for surgical intervention are:
- complete closure of the esophagus lumen,
- unsuccessful attempts to carry out bougie,
- too fast recurrent cicatricial structures,
- appearance of esophageal-tracheal, bronchopiscous fistula,
- esophageal perforation.
A special problem is batteries, elements of photographic equipment and flashlights. They can have a corrosive effect, so they must be removed immediately before the occurrence of perforation, fistula.
The most common complication is traumatic esophagitis. With the removal of a foreign body, such a problem disappears, the recovery stage begins.
Another complication is the development of obstruction of the esophagus. Usually, this does not cause a danger to the health of the patient, since treatment is in most cases carried out in a timely manner.
Prognosis and prevention of
The prognosis depends on the severity of the case and the timeliness of the treatment started. Usually it is favorable, in the case of perforation of the walls or the development of purulent processes can be serious. The lethality in the last two cases is 2%.
Preventive measures consist in the proper intake of food. Do not hurry, you need to thoroughly chew it. Elderly people need to securely fix removable dentures, for the night extract them from the mouth. Do not allow children to be in the mouth of any objects.
The video shows the removal of a foreign body from the esophagus: