Curriculum · Gastroenterology
Oesophageal foreign body
What it is
Foreign body or food bolus obstruction is the most common traumatic cause of dysphagia, and the most common object is coins. The common sites at which an object stops are the cricopharyngeus, the level of the aortic arch, and the cardia. Ingested foreign bodies usually get obstructed in three common locations: the thoracic inlet, 60% to 80%, the gastroesophageal junction, 10% to 20%, and the aortic arch, 5% to 20%. A good way to remember this is by their level in the spine: C4-C6, T8, and T4, respectively. Foreign body ingestion and aspiration have their peak occurrence between 6 months and 4 years. Dysphagia itself is difficulty with swallowing solids, liquids or both, and it is divided into oropharyngeal (high) and oesophageal (low) dysphagia, while pain on swallowing food or liquids is odynophagia.
Causes and risk
Risk factors are children, mental retardation, alcohol intoxication, an impaired swallow or cough reflex, dental, pharyngeal or airway procedures, loss of consciousness, and convulsions. Vegetable materials such as peanuts, seeds and popcorn cause more severe reactions than non organic material such as buttons and metal.