Esophageal Foreign Bodies: Epidemiology, Pathophysiology, Diagnosis, and Evidence-Based Management in High-Risk Populations

Faisal Ahmed Hassan Khormi; Ibrahim Hussain A Alanazi; Khalid Yahya H Khubrani; Ziyad Badi Alharbi; Fadhel Ghazi K Aljoudi; Raed Mohammed Abdullah Alzahrani; Ahmed Mohammed Aldhufayan; Faisal Nasser S; Alharbi Yousef Sulaiman Alharbi; Muteb Majed Fahad Albaqami

doi:10.25163/angiotherapy.8810229

Integrative Biomedical Research | Online ISSN 2207-872X

REVIEWS (Open Access)

Esophageal Foreign Bodies: Epidemiology, Pathophysiology, Diagnosis, and Evidence-Based Management in High-Risk Populations

Faisal Ahmed Hassan Khormi ¹, Ibrahim Hussain A Alanazi ¹, Khalid Yahya H Khubrani ¹, Ziyad Badi Alharbi ¹, Fadhel Ghazi K Aljoudi ¹, Raed Mohammed Abdullah Alzahrani ¹, Ahmed Mohammed Aldhufayan 1, Faisal Nasser S ¹, Alharbi Yousef Sulaiman Alharbi ¹, Muteb Majed Fahad Albaqami ¹

+ Author Affiliations

Journal of Angiotherapy 8 (8) 1-8 https://doi.org/10.25163/angiotherapy.8810229

Submitted: 01 May 2024 Revised: 08 August 2024 Published: 16 August 2024

Abstract

Esophageal foreign bodies represent a common yet potentially life-threatening emergency, posing significant diagnostic and management challenges. While many cases involve accidental ingestions with mild symptoms, high-risk populations—particularly children, the elderly, and cognitively impaired individuals—often present atypically, increasing the risk of severe complications. The clinical presentation ranges from asymptomatic cases to life-threatening conditions such as perforation and mediastinitis, necessitating prompt recognition and intervention. This review synthesizes current evidence on esophageal foreign body management, emphasizing risk stratification, diagnostic strategies, and interprofessional treatment approaches to optimize outcomes. A comprehensive literature analysis was conducted, incorporating epidemiological data, pathophysiological insights, diagnostic algorithms, and evidence-based management protocols from recent clinical studies and guidelines. Key findings include: children account for approximately 80% of cases, with coins being the most frequently ingested object; adults typically present with food impactions associated with underlying esophageal pathology; button batteries and sharp objects demand emergent removal due to a 15–35% risk of perforation; endoscopy achieves over 90% success with less than 5% complication rates; and computed tomography complements radiography for identifying radiolucent objects and complications. Importantly, interprofessional team-based management significantly improves outcomes, especially for high-risk patients. Successful treatment requires a tailored approach based on object characteristics, patient-specific factors, and the risk of complications. Prevention strategies, particularly caregiver education, remain critical in reducing incidence rates, especially among pediatric populations.

Keywords: esophageal foreign body, button battery ingestion, food impaction, endoscopic removal, interprofessional management

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