Removal of a long esophageal foreign body.

A 30-year-old woman presented to the emergency room stating that she had swallowed an entire plastic spoon. She had been eating frozen yogurt and had slipped and swallowed the clear-plastic spoon. Flexible gastroscopy revealed that the spoon was lodged in the gastric body (figure, A). A snare was used to grasp the handle of the spoon and gently withdraw it handle-first into the esophagus (figure, B). Once the tip of the spoon was in the hypopharynx, direct laryngoscopy was performed to gently remove the spoon (figure, C). Flexible esophagoscopy was then repeated to rule out any significant esophageal injury caused by the extraction. A small, superficial abrasion was found in the mid-esophagus (figure, D), with no other trauma noted.

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Although most foreign bodies (FBs) in the stomach will pass spontaneously, long FBs (>7 cm) and thin, sharp FBs have a greater propensity to become impacted and cause perforation. (1) Therefore, we remove all long and sharp FBs from the esophagus and stomach. A combination of flexible and rigid instrumentation is often beneficial.

Reference

(1.) Velitchkov NG, Grigorov GI, Losanoff JE, Kjossev KT. Ingested foreign bodies of the gastrointestinal tract: Retrospective analysis of 542 cases. World J Surg 1996;20:1001-5.

From the Scripps Center for Voice and Swallowing, La Jolla, Calif.