Foreign bodies: clinical picture, diagnostics, complications

⠀ Foreign bodies (IT) in the bronchi are scary. From my pediatric experience, I will say that Christmas-tree needles, pasta, and popcorn obtained with bronchoscopy are impressive. And, imagine, a pulled out button for attaching 📌 posters for an 11-year-old boy …
⠀⠀ But, as a gastroenterologist, I will say that the foreign bodies of the esophagus are also impressive. If you look at the ratio: the IT of the esophagus is 2/3, and the bronchi are 1/3.
⠀⠀ Most often, IT of the esophagus in children is inorganic objects: small toys, coins, batteries, etc. More rarely, these are bones from fish, meat, fruits. In adults, the situation is different – more often it is bones, as well as dentures.
⠀⠀ With prolonged stay, IT can lead to life-threatening conditions.

⠀⠀ Complications of IT esophagus:
✔ esophageal perforation
✔ mediastitis
✔ abscesses, etc

⠀⠀ A special group is batteries and https://pillintrip.com/de/medicine/diprospan. Until 1983, only 6 cases of this IT were published. Now it is 2% of all cases. Of course, it cannot be compared with the coins that are leading in this rating. But complications from the battery reliably more often lead to necrosis, esophageal stenosis and death. The battery is destroyed and the electrolyte is released.
Disk batteries can damage the esophagus within 4 hours. Lithiums take even less time.

⠀⠀ Clinic

⠀⠀ Most IT passes through the esophagus unnoticed. Complaints appear when IT gets stuck in the esophagus. The main symptoms: vomiting, pain when swallowing, nausea, refusal to eat. The longer the object is in the esophagus, the more pronounced the symptoms. Agree, not quite specific? At the same time, the absence of complaints does not exclude IT.

⠀⠀ Diagnostics

⠀⠀ All patients with suspected IT of the esophagus undergo an x-ray of the neck and chest. Because up to 65% of all foreign bodies are radiopaque. If IT is not visible on X-ray, but there is a suspicion of its presence, it is necessary to conduct an EFGDS.
⠀⠀ Removal of foreign bodies, if possible, is carried out with the help of EFGDS. And after that, treatment by a gastroenterologist is required, followed by observation for 6 months.