Esophageal foreign bodies are more common in dogs than cats. Bones are the most common foreign body, but needles, fishhooks, wood and rawhides may also become lodged in the esophagus. Objects usually lodge in the areas of the esophagus with the least distensibility: base of the heart, at the level of the diaphragm and lower neck at the inlet to the chest cavity.
Clinical Signs
Drooling, gagging, regurgitation, anorexia and repeated attempts to swallow are signs of an esophageal foreign body. The signs depend on the location of the foreign body and the degree and duration of obstruction. A partial obstruction may allow fluids but not food to pass. With a chronic obstruction, anorexia, weight loss, and lethargy are common.
Drooling, gagging, regurgitation, anorexia and repeated attempts to swallow are signs of an esophageal foreign body. The signs depend on the location of the foreign body and the degree and duration of obstruction. A partial obstruction may allow fluids but not food to pass. With a chronic obstruction, anorexia, weight loss, and lethargy are common.
Perforation of the cervical esophagus may result in local abscessation or subcutaneous emphysema; perforation of the thoracic esophagus may result in air, bacteria and food to enter the thoracic cavity causing severe, life threatening complications. Esophagitis, mucosal laceration, esophageal stricture, and esophageal diverticulum formation are potential complications. Esophageal stricture formation is the most common complication associated with an esophageal foreign body. Aspiration pneumonia may also be seen secondary to the regurgitation.
Diagnosis
Many esophageal foreign bodies are radiopaque and can be seen on plain radiographs. A contrast esophagram or esophagoscopy may be required to identify radiolucent foreign bodies such as plastics.
Many esophageal foreign bodies are radiopaque and can be seen on plain radiographs. A contrast esophagram or esophagoscopy may be required to identify radiolucent foreign bodies such as plastics.
Treatment
Esophageal foreign bodies, once diagnosed, should be removed immediately. Most often, a foreign body can be removed with a flexible endoscope and forceps. If a foreign body cannot be removed via endoscope or forceps then it may be pushed into the stomach where it can either be digested (eg, bones), passed, or removed via a gastrotomy. Surgery is indicated if a perforation has occurred or the foreign body cannot be removed via endoscopy; in one study, the recovery rate was 93% after surgery. There is potential for stricture formation and complications secondary to the poor wound healing ability of the esophagus.
Case of the month
Patient is an 11 year old female spayed miniature pinscher that presented for vomiting and anorexia for 4 days. Owner reported that patient did get into the garbage 5 days prior. On physical exam p was quiet, but alert. A hard object was palpated in the patients esophagus. Radiographs revealed an esophageal foreign body. The patient was transferred for endoscopy and foreign body removal. A large bone was removed from the esophagus. The patient recovered well with no complications.
Esophageal foreign bodies, once diagnosed, should be removed immediately. Most often, a foreign body can be removed with a flexible endoscope and forceps. If a foreign body cannot be removed via endoscope or forceps then it may be pushed into the stomach where it can either be digested (eg, bones), passed, or removed via a gastrotomy. Surgery is indicated if a perforation has occurred or the foreign body cannot be removed via endoscopy; in one study, the recovery rate was 93% after surgery. There is potential for stricture formation and complications secondary to the poor wound healing ability of the esophagus.
Case of the month
Patient is an 11 year old female spayed miniature pinscher that presented for vomiting and anorexia for 4 days. Owner reported that patient did get into the garbage 5 days prior. On physical exam p was quiet, but alert. A hard object was palpated in the patients esophagus. Radiographs revealed an esophageal foreign body. The patient was transferred for endoscopy and foreign body removal. A large bone was removed from the esophagus. The patient recovered well with no complications.
