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Oesophageal foreign bodies should be removed promptly to reduce the extent of mucosal damage, ulceration, perforation and subsequent stricture formation.
Oesophageal foreign bodies should be removed promptly to reduce the extent of mucosal damage, ulceration, perforation and subsequent stricture formation.
'''Endoscopic removal''' with grasping forceps is the method of choice for removing foreign bodies unless the object is too firmly lodged to pull free or radiographs of the chest suggest that the oesophagus has been perforated. If the object too large to be safely removed through the mouth, it may be possible to push it into the stomach and remove it surgically via a gastrotomy.
'''Endoscopic removal''' with grasping forceps is the method of choice for removing foreign bodies unless the object is too firmly lodged to pull free or radiographs of the chest suggest that the oesophagus has been perforated. If the object is too large to be safely removed through the mouth, it may be possible to push it into the stomach and remove it surgically via a gastrotomy.
If endoscopic removal is not possible, the foreign must be removed surgically. The approach used depends on the exact location of the object. In the '''cervical oesophagus''', a ventral midline cervical approach is made and the trachea is retracted to the right to expose the oesophagus but in the '''thoracic oesophagus''', a lateral (intercostal) thoracotomy or median sternotomy is performed. As the chest cavity is entered in either approach, the patient must be ventilated. In the '''abdominal oesophagus''', a ventral midline coeliotomy is performed.
If endoscopic removal is not possible, the foreign must be removed surgically. The approach used depends on the exact location of the object. In the '''cervical oesophagus''', a ventral midline cervical approach is made and the trachea is retracted to the right to expose the oesophagus but in the '''thoracic oesophagus''', a lateral (intercostal) thoracotomy or median sternotomy is performed. As the chest cavity is entered in either approach, the patient must be ventilated. In the '''abdominal oesophagus''', a ventral midline coeliotomy is performed.