Answer:
Yes. Glucagon given intravenously may be effective in meat impactions of the lower esophagus. Glucagon acts by relaxing the lower esophageal sphincter. It does not appear to be effective in upper-or mid esophageal foreign bodies. It also does not affect peristalsis once the sphincter is relaxed. The weight of the object itself or the barium [...]
Archive for the 'Foreign Bodies' Category
Question: Are there any noninvasive means of removal of esophageal foreign bodies?
Sunday, September 23rd, 2007Posted in Foreign Bodies | No Comments »
Question: What are the complications of Esophageal Foreign Bodies?
Sunday, September 23rd, 2007Answer:
Esophageal perforation or abscess formation occurs in 0.6%- 1.0%, which is generally caused by sharp objects or prolonged impaction, or it is iatrogenically produced secondary to removal. Minor complications such as esophageal abrasions and lacerations occur in 1%.
Airway obstruction usually occurs in children only when a large bolus is impacted, causing compression of the posterior [...]
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Question: Where do esophageal foreign bodies usually lodge?
Thursday, September 20th, 2007Answer:
Over 90% below the level of the cricopharyngeal muscle. The four most common areas are:
At the level of the cricopharyngeal muscle
At the level of the aortic arch and left mainstem bronchus
At the esophageal gastric junction
At pathologic sites of narrowing such as Zenker’s diverticulum and esophageal strictures
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Question: What is the immediate concern or threat to life in a patient with an esophageal foreign body?
Wednesday, September 19th, 2007Answer:
To ensure that the airway is clear and that the foreign body is not in the upper airway or trachea
To rule out esophageal perforation, which is evidenced by presence of fever, subcutaneous air, severe chest pain on physical examination, pneumomediastinum on chest x-ray, or soft tissue air on neck films.
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Question: How do you evaluate the patient with a fish bone in the throat?
Monday, September 17th, 2007Answer:
The dilemma of a fish bone in the throat is whether the symptoms are caused by a retained foreign body or mucosal abrasion. Tenderness on palpation of the neck is an unreliable sign, whereas pooled secretions on laryngoscopy almost always are associated with a retained foreign body. Careful physician examination with visualization and removal of [...]
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Question: Do children with possible coin ingestion and no symptoms need a radiograph?
Monday, September 17th, 2007Answer:
Yes. Many children with an esophageal coin are asymptomatic. Delayed diagnosis may lead to mistreatment and complications resulting from esophageal erosion, such as bleeding, perforation, and obstruction. In general, if the coin passes the gastroesophageal junction, it traverses the remainder of the GI tract without complication. Subtle symptoms, such as failure to thrive, eating [...]
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Question: How do you handle the adult with an esophageal foreign body?
Saturday, September 15th, 2007Answer:
A careful history is crucial to the management of such patients. More than 80% of swallowed foreign bodies pass through the gastrointestinal (GI) tract without incident. Sharp objects (e.g., bones, needles, wire) may impale the wall of the esophagus, whereas soft objects, such as meat, may obstruct the anatomic points of constriction of the esophagus: [...]
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