Tag Archives: Esophageal obstruction

8/22 MR with Justin + Dr. Schlager: Dysphagia + Food impaction

An elderly woman w/ a history of esophageal cancer (s/p endoscopic mucosal resection) presents with acute on chronic dysphagia. Her initial workup was unrevealing for stricture and CT showed a nonspecific filling defect, which was ultimately found to be an undigested hot dog!
Management of foreign body impaction: 
Emergent endoscopy
-Complete esophageal obstruction with inability to handle oral secretions
-Disk batteries int he esophagus
-Sharp pointed objects in the esophagus
Urgent endoscopy (within 24h)
-Esophageal objects that are blunt
-Esophageal objects without complete obstruction
-Magnets
-Anything > 6cm in length
Non-Urgent endoscopy
-Blunt objects that fail to pass the stomach or advance in the duodenum in 3-4 weeks
-Disk batteries in the stomach
Conservative management (observe with weekly radiographs and determine need for endoscopy later)
-Blunt objects that have already made it to the stomach or beyond
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