Under the foreign body of the esophagus is understood the phenomenon of ingestion and jamming in its channel of foreign objects, food particles that were swallowed intentionally or accidentally. This condition requires urgent help to avoid the occurrence of bleeding, suffocation, perforation of the esophagus, and other complications.
Most often, a foreign body in the esophagus is found in young children, prone to taste everything. In adult patients, such phenomena are observed against the background of mental disorders, with inattentive cooking, improper handling of food.
A foreign object is removed from the esophagus, taking into account the foreign body material and its location. Therapy consists in endoscopic extraction and subsequent drug maintenance of the esophagus.
Causes
The main cause of a foreign body entering the esophagus is the careless use of food. Laughing or talking while eating can involuntarily swallow large amounts of food that is unable to pass through the esophagus.
At risk are also people who constantly keep something in their teeth. Such objects can enter not only the esophagus, but also the respiratory tract, causing aspiration asphyxiation and subsequent death.
Most often, gastroenterologists and surgeons find stuck food particles, fish bones, small metal objects, dental crowns, removable dentures in the esophagus. Small parts of toys, elements of designers, pins, coins are most often extracted from children's esophagus. If a sharp object gets into the esophagus, it can damage the mucous membranes inside the organs. In this case, its extraction is very difficult, the likelihood of complications increases.
If swallowed, the foreign body gets stuck in the area where the esophageal tube naturally narrows. A lot of objects are in the area closer to the oral cavity, and large objects get stuck in the area of chest narrowing. As a rule, parts of prostheses, fruit bones, and non-processed foods fall into the lower parts of the esophagus.
Provocative factors
The main triggering factors are:
- haste when eating, insufficient chewing;
- poor fixation of prostheses;
- the habit of holding foreign objects in your teeth;
- mental disorders;
- pathology of the esophagus, accompanied by violations in the structure of the esophagus;
- ulcers, diverticulitis, neoplasms.
Symptoms of a foreign body entering the esophagus
Detection of an external object in the human body is detected by observing the corresponding symptoms. A foreign body in the esophagus and the symptoms of its presence in its manifestations depend on the nature of the object itself, its size, material, borders, shape. First of all, such a symptom is manifested as a feeling of compression in the chest area. The cause of this phenomenon is esophagospasm.
The described pathology is so widespread and often found in patients that the International Classification of Diseases (ICD) assigned it a separate place in the list of existing ailments. A patient with a foreign body of the esophagus (ICD-10 code: T18.1) develops sore throat. If the lumen of the esophagus overlaps significantly, dysphagia begins to develop, that is, a person loses the ability to swallow saliva normally. In the event of severe damage to the walls of the esophagus, reverse reflux of food to the oral cavity develops. There is also an increased saliva, general weakness, palpitations.
When squeezing the trachea and larynx with a foreign body in the esophagus, there is a change in voice, the appearance of stridorous breathing, bluish skin and other symptoms of suffocation. Severe symptoms appear, as a rule, in young children - they begin to cough strongly, cannot take a breath, the skin turns blue, the appearance of false croup is noted.
Symptomatic buildup
If the victim is not helped in time, the symptoms of a foreign body in the esophagus (ICD code: T18.1) will begin to increase.
- An increase in temperature occurs.
- Inflammation of a purulent nature develops.
- The pain is felt stronger and worse during swallowing.
- Swelling of the neck occurs.
With a long stay of a foreign object in the esophagus, there is a possibility of a fistula, a connection of the trachea with the esophagus wall and the development of pneumotorox. A foreign body can damage nerves, blood vessels, causing vomiting of blood, bleeding, and in some cases death.
Urgent Care
If a foreign object is stuck in the esophagus, airway blockage may occur. In this case, the victim needs immediate assistance. Experts recommend using the “5 + 5” technique. What does he mean?
- It is necessary to inflict 5 injuries to the victim in the area of the shoulder blades on the back.
- Perform the Heimlich technique - make 5 shocks to the diaphragm area.
- Repeat these steps until the patient’s breathing is fully restored.
Perform the reception of Heimlich should be subject to certain rules.
- It is necessary to take a position behind the victim, grab his arms around his stomach, tilt forward a little.
- Put one brush into a fist and place it in the area above the belly button.
- With the other hand you should grab your fist and press hard.
- It is necessary to repeat tremors until the foreign body is displaced and breathing is restored.
Do it yourself
When performing Heimlich’s technique regarding himself, one should also adhere to a specific sequence of actions.
- You should clench your fist and place it above the navel.
- Grasp your fist with your other hand.
- Tilt your torso forward.
- Fist a quick push into the stomach.
Before you begin to provide first aid, you should call an ambulance. If a battery or a sharp object has got into the esophagus, it is necessary to act immediately, since such foreign bodies can damage the esophagus walls and penetrate their thickness.
Diagnostics
How is the diagnosis of foreign bodies of the esophagus?
In the absence of breathing difficulties and a satisfactory condition of the patient, the doctor prescribes diagnostics in the form of x-ray examination and esophagoscopy. The research results make it possible to assess the integrity of the esophagus, the degree of damage, and select treatment tactics.
Therapies
The basis of therapy for the foreign body of the esophagus (ICD-10 code: T18.1) is surgery. The patient is assigned to retrieve the item using an endoscope. After the item is removed, the patient is prescribed drug therapy in order to restore the mucous walls of the esophagus.
After the process of extracting a foreign object, sometimes complications arise due to the ingress of a foreign body into the esophagus (ICD-10: T18.1). Treatment of affected mucous membranes, scratched tissue walls and a simple sensation is necessary without delay in order to prevent an even greater deterioration in the patient's health.
In the presence of severe purulent inflammation, drainage and subsequent cleaning of the affected area are indicated. For some time after surgical manipulation, the patient will have to eat with a probe. In the rehabilitation period, you should adhere to a sparing diet.
Conservative therapy of pathology
After removing the foreign body of the esophagus (ICD-10 code was indicated earlier), detoxification and anti-inflammatory therapy are prescribed. For this, solutions and tablet medicines are used. If the patient's condition is severe, electrolytes and colloidal preparations should be administered. Also, experts prescribe antacids and antibacterial medications to reduce the impact of negative factors on the damaged esophagus.
Therapy may include the use of necessary medications to correct the patient.
- "De Nol", which promotes the regeneration of damaged cells, prevents the production of acid, normalizes blood circulation.
- "Iberogast", which allows you to normalize the process of passage of food, eliminate dysphagia, reduce acidity, restore muscle tone.
- Omeprazole, Almagel, which reduce the process of inflammation and inhibit the production of an acid that impedes healing.
For detoxification used: "Gluconeogenesis", "Reomacrodex", "Reopoliglyukin." Drug therapy should also be supplemented with vitamin complexes. In the recovery period, the patient is shown the use of immunostimulants - "Prodigiosana", "Immunal", "Taktivina", "Timogen".
Endoscopic Extraction
The removal of the foreign body of the esophagus (according to ICD-10 of this pathology is assigned the code T18.1) is carried out using an endoscope with two biopsy channels. Before manipulation, local anesthesia or general anesthesia is performed. Using an endoscope, the surgeon correctly orientates the foreign object so that it passes through the narrowing region with the smallest diameter. When removing, there is a risk of perforation, damage to the walls.
There are a number of features in the treatment of patients with a foreign body in the esophagus. What are these features?
- Examination, treatment should be carried out in a hospital setting urgently.
- For diagnosis, radiography, endoscopy are used.
- The risk of perforation can be reduced by the use of endotracheal anesthesia, which also accelerates the extraction of the subject.
- As a rule, flexible endoscopes with different diameters are used. This allows you to improve the quality of diagnosis, reduce the risk of trauma to the walls of the esophagus.
- The postoperative method of feeding a patient is determined individually: it can be food using a probe or gastrostomy.
After surgical manipulation, the patient is transferred to the surgical department for further diagnosis of probable complications and observation.
What are the possible complications of such a pathology?
Emergency extraction of a third-party item is carried out in order to prevent the development of the following complications:
- periesophagitis, mediastinitis;
- the formation of an esophageal-tracheal fistula;
- decomposition of a foreign body with subsequent intoxication of the body;
- the occurrence of perforation of the esophagus;
- subcutaneous emphysema;
- spread of infection to nearby organs.
Identify complications allows general symptoms. The purulent process will be indicated by an increase in temperature, poisoning of the body, the appearance of severe pain in the head, the preservation of sensation in the esophagus of a foreign body.
The prognosis of patient therapy is always positive. Only with a late call to a specialist and the appearance of dangerous complications after a foreign body enters the esophagus is there a chance of death.
Preventive measures include getting rid of bad habits with food. It is also necessary to ensure that young children do not play with small objects that they can swallow.