Diagnostic modalities and therapeutic principles of esophageal foreign bodies - experience of ENT Clinic Craiova within the County Emergency Hospital

Abstract

The purpose of this paper. The importance of total dysphagia caused by esophageal foreign bodies with an impact upon the esophageal walls. The objectives of this paper. Clinical and imagistic diagnosis in determining the technique that must be used for the extraction of foreign bodies: rigid esophagoscope or external cervicotomy. Materials and method. Patients hospitalized in the ENT Clinic over a period of 5 years (2012-2016) with ingested foreign bodies, dysphagia and esophageal affectation. Results and discussions. After an analysis of the 155 hospitalised patients, it could be noticed that enclavation was conducted on a normal esophagus in 58% of cases and on a pathological esophagus in 42% of cases. The foreign bodies enclaved on the normal esophagus were large-sized food items (meat, cartilages, pointed bones), dentures, usually stagnating, and were prevented from swallowing at the mouth of esophagus. On a stenosed post-caustic esophagus there have been small-sized food items (peas, beans, cherry stones), depending on whether it was a case of simple or multi-levelled stenosis. In children, the ingested foreign bodies were metallic (coins) or plastic (buttons, LEGO toys) stucked in cervical esophagus(2). It was not difficult to set the diagnosis of esophageal foreign body, as patients or relatives described how the foreign body was ingested. Radiological examination was compulsory in order to emphasise any potential parietal changes with mediastinal disorder of the pointed foreign bodies, and it was conducted urgently, consisting in esophagoscopy (the diagnosis method) and the extraction of the foreign body in a secure, painless manner. Conclusions. The manoeuvres for the natural extraction of the foreign body by means of endoscopic control or external cervicotomy must be conducted as soon as possible after ingestion, with 24-hour hospital observation after the extraction of the foreign body.