Foreign Bodies of Food Passage | Investigations and Management

The key element of this sqadia.com medical V-learning lecture is the foreign bodies of food passage. This lecture aims to elaborate lodgement of ingested foreign bodies in the tonsil, and pyriform fossa. Afterwards, investigations of radiolucent foreign bodies and management are highlighted along with cervical oesophagotomy and transthoracic oesophagotomy. Furthermore, disc batteries and dysphagia are also discussed.

▬ 📌 Ingested Foreign Body
The ingested foreign body may lodge in the tonsil, base of the tongue, or pyriform fossa. Tonsil Can be easily observed by oropharyngeal examination. The base of the tongue or vallecula is observed by mirror examination. Likewise, information about the posterior pharyngeal wall and pyriform fossa is conveyed. A coin, piece of meat, denture, or safety pin are types of foreign bodies that get lodged in the oesophagus.

▬ 📌 Site of Lodgement and Clinical Features
The commonest site of lodgement of the foreign body is at or below the cricopharyngeal sphincter. Dr. Saima Mushtaq also informs that sharp or pointed objects lodge anywhere in the oesophagus. Symptoms include a history of initial choking or gagging, dysphagia, and drooling of saliva. Moreover, signs involve tenderness in the lower part of the neck and pooling of secretions.

▬ 📌 Investigations and Management
Investigations of radiolucent foreign bodies may show air bubbles in the cervical oesophagus. Barium swallow delays subsequent endoscopic procedures. Subsequently, management is pursued. Then tabular representation of rigid and flexible oesophagoscopy comparison is given. The procedure of cervical oesophagotomy is also considered. Then the focus is shifted toward transthoracic oesophagotomy for impacted foreign bodies of the thoracic oesophagus.

▬ 📌 Disc Batteries
Medical specialist begins by elaborating on disc batteries which contain NaOH, KOH, and Hg, and leaks to cause oesophageal injury. Then, some caveats in the oesophageal foreign body are highlighted. Respiratory obstruction, peri oesophageal cellulitis and abscess, perforation, tracheo-oesophageal fistula, and ulceration and stricture are the complications of the oesophageal foreign body.

▬ 📌 Dysphagia
Dysphagia is difficulty in swallowing. Odynophagia is used when swallowing causes pain. After that, Dr. Saima Mushtaq talks about aetiology. Preoesophadeal causes are categorized into the oral phase and pharyngeal phase. Oesophageal causes are lumen, wall, and outside the wall. To know comprehensively about this section, watch the full-length lecture on sqadia.com. Moreover, manometric and pH studies are pursued lastly.

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