News & Perspective
Drugs & Diseases
CME & Education
Academy
Video
Edition: ENGLISH
DEUTSCH
ESPAÑOL
FRANÇAIS
PORTUGUÊS
Sign Up It's Free!
Edition: ENGLISH DEUTSCH ESPAÑOL FRANÇAIS PORTUGUÊS

No Results

    News & Perspective Drugs & Diseases CME & Education Academy Video
    Drugs & Diseases > Emergency Medicine

    Gastrointestinal Foreign Bodies Clinical Presentation

    Updated: Jan 04, 2018
    • Author: David W Munter, MD, MBA; Chief Editor: Steven C Dronen, MD, FAAEM  more...
    • Print
    Presentation

    History

    Oropharyngeal foreign bodies

    Patients with oropharyngeal foreign bodies normally present with a foreign body sensation, especially after eating chicken or fish, although a variety of other objects, including toothpicks, may be involved.

    They may have variable degrees of discomfort, from minor to more severe. Patients may complain of inability to swallow or handle secretions.

    Rarely, patients may have airway compromise, typically in delayed presentations with subsequent infection or perforation.

    Patients can usually localize the foreign body sensation in the oropharynx.

    Esophageal foreign bodies

    Adults with esophageal foreign bodies usually present acutely, with a history of ingestion. A foreign body sensation or vague discomfort in the epigastrium suggests that the foreign body is entrapped at the LES.

    Dysphagia is the norm in adults. If the obstruction is complete, an inability to handle secretions is common. The classic adult presentation is the person with dentures who has had some alcohol and is eating meat. Incomplete chewing leads to an impaction at the LES. Adults should be asked about the use of dentures, alcohol intake, and circumstances surrounding the ingestion.

    In children with esophageal foreign bodies, the history may be less clear. [11, 19] As many as 35% of children with esophageal foreign bodies are asymptomatic; the history is given by a parent who has seen the child with an object in his or her mouth and suspects the child might have swallowed it. Such reports must be taken seriously and investigated. [20] Gagging, vomiting, and neck or throat pain are common presentations. Children with chronic esophageal foreign bodies may also present with poor feeding; irritability; failure to thrive; fever; stridor [21] ; or pulmonary symptoms, such as repetitive pneumonias from aspiration. [22] Large esophageal foreign bodies at the UES can cause tracheal impingement in children, with resultant stridor or respiratory compromise.

    Stomach/small intestine foreign bodies

    Patients with foreign bodies in the stomach or small intestine may present with a history of swallowing an object, which has passed through the esophagus.

    Patients may present with vague symptoms such as fever, abdominal pain, or vomiting.

    Next:

    Physical Examination

    The physical examination typically is not helpful, but the oropharynx, neck, chest, lungs, heart, and abdomen should be carefully examined.

    Occasionally, a foreign body in the oropharynx can be visualized and removed. In cooperative patients, indirect laryngoscopy or fiberoptic nasopharyngoscopy provides better information than a direct examination.

    In children, tracheal compression and stridor suggest a large foreign body at the upper esophageal sphincter.

    Complete obstructions can cause drooling and the inability to swallow.

    Delayed presentations may be accompanied by signs of infection, including peritonitis.

    Previous
    Differential Diagnoses
     
     
    Media Gallery
    of 4

    Find Us On

    Group 2 34A8E98B-62ED-4216-98D6-E986304F4C2E

    About

    About Medscape Privacy Policy Editorial Policy Cookies Terms of Use Advertising Policy Help Center

    Membership

    Become a Member Email Newsletters Manage My Account

    Apps

    Medscape MedPulse News CME & Education

    WebMD Network

    WebMD MedicineNet eMedicineHealth RxList WebMD Corporate

    Editions

    English Deutsch Español Français Português
    All material on this website is protected by copyright, Copyright © 1994-2019 by WebMD LLC. This website also contains material copyrighted by 3rd parties.