Gastrointestinal Foreign Bodies Differential Diagnoses

Updated: Feb 20, 2014
  • Author: David W Munter, MD, MBA; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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DDx

Diagnostic Considerations

Other conditions to consider in the differential diagnosis of patients with suspected gastrointestinal foreign bodies include the following:

  • Dysphagia
  • Esophageal carcinoma
  • Esophageal stricture
  • Failure to thrive
  • Intestinal perforation
  • Odynophagia
  • Peritonitis
  • Pneumomediastinum

Important considerations

The following are important things to consider in patients with gastrointestinal foreign bodies:

  • Toothpicks, when ingested, have a high risk of complications, and persons with this foreign body should be treated with early endoscopy.
  • Patients with button batteries in the esophagus are at a high risk for esophageal necrosis. Urgent removal is mandatory.
  • Aluminum soda can tabs are not visualized on plain radiographs and are frequently entrapped in the esophagus. Early endoscopy is indicated if the ingestion is definitive; if unclear, localization of the soda can tab can be visualized via CT scanning.
  • Foley catheter removal of esophageal foreign bodies should be performed only in carefully selected patients and only by those who are experienced in its use who have emergency airway equipment immediately available.
  • Children with esophageal foreign bodies may present with minimal or no symptoms. Evaluate all children who may have swallowed an object.
  • Children with chronic esophageal foreign bodies may present with vague symptoms such as irritability, poor feeding, or pulmonary symptoms. Maintain a high index of suspicion for an esophageal foreign body.

Further reading

Digoy GP. Diagnosis and management of upper aerodigestive tract foreign bodies. Otolaryngol Clin North Am. 2008 Jun;41(3):485-96, vii-viii. PMID: 18435994.

Munter DW, Esophageal foreign bodies. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, PA: Saunders; 2010:715-33.

Differential Diagnoses