A review of the current management of impacted foreign bodies in the oesophagus in adults

Abstract

Patients with acute oesophageal obstruction, either due to a foreign body or food bolus, present to any of the specialties of Otorhinolaryngology, General Surgery, Cardiothoracic Surgery or Gastroenterology. To review current routine management of this condition, we conducted a postal survey of all the consultants in the aforementioned specialties in the South Thames region. The aims of the survey were to assess current practice and to produce a standardized management plan for these patients.

A rare case of foreign body impaction requiring oesophagotomy

“…1 The majority of ingested foreign bodies resolve spontaneously without causing complications. 2,3 However, it is a potentially serious condition that can result in oesophageal perforation and mediastinitis if left untreated. 4 Most cases of foreign body ingestion occur in the paediatric population (peak incidence 6 months -6 years).…”

Causes of bolus impaction in the esophagus

“…Longstreth et al [2] and other authors [12,[20][21][22][23] reported that flexible esophagoscopy permitted disimpaction in 98% of cases. The esophageal perforation rates with flexible endoscopy have been reported to be between 0.018 and 0.05% as opposed to between 0.2 and 1.2% using rigid endoscopy [24,25]. In most cases the cause of the Total 54 bolus impaction is unknown at the time of removal.…”

Surgical Treatment of Acute Mediastinitis Due to Fish Bone

“…There is a long list of serious complications as a consequence of esophageal foreign bodies, including perforation, retropharyngeal abscess, mediastinitis, and fistulas [6]. The mortality rates are as high as 50% as a result of subsequent intrathoracic infection [7]. Conservative or surgery are the treatment modalities for mediastinitis.…”