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===Diagnostic Imaging===
===Diagnostic Imaging===
Palpation of the cervical oesophagus can occasionally reveal a foreign body but a definitive diagnosis usually requires radiography.
Palpation of the cervical oesophagus can occasionally reveal a foreign body but a definitive diagnosis usually requires radiography.
Plain thoracic radiographs reveal oesophageal foreign bodies that are radiodense. Poultry bones or other items that are less radiodense may be more difficult to visualise.
Plain thoracic radiographs reveal oesophageal foreign bodies that are radiodense. Poultry bones or other items that are less radiodense may be more difficult to visualise.
It is important to look for signs of oesophageal perforation such as pneumothorax, pleural effusion and fluid in the mediastinum.
It is important to look for signs of oesophageal perforation such as pneumothorax, pleural effusion and fluid in the mediastinum.
Contrast radiography is rarely necessary but may be used to identify radiolucent foreign objects. Contrast agents must be used with caution if there is suspicion of oesophageal perforation.
Oesophagoscopy can be used to provide a definitive diagnosis of an oesophageal foreign body.
==Treatment==
==Treatment==
Oseophageal foreign bodies should be removed promptly to reduce the incidence of mucosal damage, ulceration and perforation.
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 suggest perforation
Thoracotomy is required in these cases.
If the object too large to be safely removed through the mouth it may be possible to push it into the stomach followed by surgical removal via a gastrotomy.
Post foreign object removal:
*Oesophageal mucosa should be inspected endoscopically to assess for any damage.
*Thoracic radiographs to look for pneumothorax caused by oesophageal perforation.
*Antibiotic therapy.
*H<sub>2</sub>O
Mild oesophagitis:
Mild oesophagitis:
*withdraw oral food for 2-3 days and manage as an outpatient.
*withdraw oral food for 2-3 days and manage as an outpatient.