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upper digestive tract (Foreign bodies (Treatment (The sun should never…
upper digestive tract
Foreign bodies
- Typically lodged in the hypopharynx or in the upper constriction of the esophagus
- small children
- Older patients (typically those with the decreased sensation in the hard palate (e.g. due to a maxillary denture)
Symptoms
- A feeling of pressure, „pricking” sensation
- dysphagia (difficulty in swallowing)
- odynophagia (pain on swallowing)
- attacks of coughing (seldom)
- pain in the hypopharynx or rertosternal area
Diagnosis
- History (dysphagia, odynophagia)
- Inspection and palpation
- Indirect mirror examination of the hypopharynx
Treatment
- The sun should never rise and set on a foregin body !!!
- Cervical esophagotomy or thoracotomy (if esophgoscopy doesn`t succeed)
If a foreign body is suspected, the hypopharynx and esophagus MUST be inspected endoscopically even if radiographs are negative.
Complications
Bleeding, Iatrogenic perforation of the esophagus, Mediastinitis
divericula
- Pulsion divericula: Mucosa herniates through a weak point in the muscular coat due to a rise of intraluminal pressure
- Traction diverticula: found at parabronchial sites due to scar traction following hilar lymphadenitis and involve all layers of the esophageal wall
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