Korean J Gastroenterol.  2018 Jul;72(1):1-5. 10.4166/kjg.2018.72.1.1.

Esophageal Foreign Body: Treatment and Complications

• Boo SJ
• Kim HU

• KMID: 2416928
• DOI: http://doi.org/10.4166/kjg.2018.72.1.1

Abstract

The most common cause of esophageal foreign bodies in adults is meat in Western countries and fish bones in Asian countries, including Korea. Although most ingested foreign bodies pass spontaneously through the esophagus without any clinical sequelae, some sharp foreign bodies, such as fish bones embedded in the esophagus, require treatment. Endoscopic management is the first choice in the treatment of esophageal foreign bodies because it is quite safe and effective. Major complications occur as a result of esophageal perforation; in particular, sharp foreign bodies, such as fish bones, are more likely to cause perforation. Complications include mediastinitis, paraesophageal abscess, pneumomediastinum, subcutaneous emphysema, pneumothorax, tracheoesophagal fistula, aortoesophageal fistula, aspiration, and asphyxia. Unnecessary delays should be avoided in endoscopic intervention for esophageal foreign bodies to prevent complications.

Keyword

Esophagus; Foreign bodies; Therapy; Complications

MeSH Terms

Abscess
Adult
Asian Continental Ancestry Group
Asphyxia
Esophageal Perforation
Esophagus
Fistula
Foreign Bodies*
Humans
Korea
Meat
Mediastinal Emphysema
Mediastinitis
Pneumothorax
Subcutaneous Emphysema

Figure

• 

  Fig. 1 A esophageal fish bone foreign body. (A) The chest computed tomography shows a curvilinear radio-opaque density in the distal esophagus. (B) There is a fish bone penetrated both sides of the esophageal wall. (C) The fish bone is being removed with the alligator forceps under cap-fitted endoscopy. (D) The removed foreign body is a fish bone about 4 cm in size.

• 

  Fig. 2 A esophageal fish hook foreign body. (A, B) The plain X-ray films of the neck reveals a curved radio-opaque foreign body in the cervical esophagus. (C) The fish hook is being extracted with the rat tooth forceps under cap-fitted endoscopy. (D) The removed foreign body is a fish hook about 3 cm in size.

• 

  Fig. 3 A impacted food bolus in the esophagus. (A) There is a food bolus (chicken meats) in the mid-esophagus. (B, C) The food bolus is being removed endoscopically using the retrieval net. (D) Post-ESD stricture developed in the distal esophagus after ESD for superficial esophageal cancer two months ago. ESD, endoscopic submucosal dissection.

• 

  Fig. 4 Complications of esophageal foreign bodies. (A) The esophageal endoscopy shows esophageal ulcer with perforation caused by fish bone. (B) Endoscopic treatment of the perforation site was performed with endoclips. (C) The chest computed tomography reveals pneumomediastinum (yellow arrow) at the tip of the fish bone that caused esophageal perforation in a patient who ingested fish bone three days ago. (D) The chest computed tomography shows paraesophageal abscess (yellow dotted circle) in a patient who ingested fish bone a week ago.

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