Ingested foreign bodies can lodge in:

  • Tonsil: Usually sharp fish bones, needles etc.
  • The base of tongue: Fish bone or a needles.
  • Pyriform fossa: Fish bone, chicken bone, needle or dentures are commonly seen.
  • Oesophagus: Coins, piece of meat, chicken bones, denture, safety pin, marble.


  • Age: Children more prone as they play with coins, marbles and accidently ingest them.
  • Loss of protective mechanism: Use of upper denture prevents tactile sensation and a foreign body is swallowed undetected.
  • Inadequate mastication.
  • Oesophageal stricture, spasm.
  • Psychotics.

Constrictions of Oesophagus:

  • Sites of lodgment of foreign body in the Oesophagus:
    • Just below cricopharyngeal sphincter.
    • Flat objects like coins are held up at the sphincter while others are held in the upper oesophagus just below sphincter.
    • At the broncho-aortic constriction.
    • Sharp or pointed foreign bodies can be impacted anywhere in the oesophagus.

Clinical features:

  • Symptoms:
    • History of choking.
    • Discomfort or pain just above the clavicle.
    • Dysphagia (difficulty in swallowing).
    • Drooling of saliva.
    • Respiratory distress, dyspnea, cough and wheezing. These symptoms are due to compression overflow or fistulous communication with the air passages.
    • Substernal or epigastric pain.
  • Signs:
    • Tenderness in the lower part of neck on the right or left side of trachea.
    • Pooling of saliva in pyriform fossa as seen on indirect laryngoscopy.
    • Foreign body may be seen protruding from Oesophageal opening in post-cricoid region.


  • Rigid Oesophagoscopy under general anesthesia is usually safest and the best method of removal of Foreign bodies.
  • If such foreign bodies cannot be removed by the above, then transthoracic oesophagotomy is done.
  • Blunt non-impacted foreign bodies can be removed by fibre optic oesophagoscopy especially in high-risk patients.

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