Removal of Sharp Esophageal Foreign Body
James R Tate, MD (presenter); Chetan Gujrathi MD
Sacramento CA; Toronto AZ

OBJECTIVES: 1. To understand the methods available for extraction of unusual sharp esophageal foreign bodies. 2. Be able to choose these methods appropriately.
METHODS: Case report examining one patient with three unusual sharp esophageal foreign bodies in a university setting.
RESULTS: Successful removal of three sharp esophagel foreign bodies using rigid esophagoscopy.
CONCLUSIONS: There is controversy regarding the best approach for removing an esophagel foreign body: flexible fiberoptic esophagoscope vs. rigid esophagoscope. The use of flexible fiberoptic endoscopy for removal of esophageal foreign bodies has proven to be a safe and effective tool. However, sharp foreign bodies present a challenge. The choice of endoscopy should be dictated by the type of foreign body being removed and the location of the foreign body within the esophagus. This case report illustrates a circumstance in which rigid endoscopy is preferred because the object can be introduced into the lumen of the esophagoscope and withdrawn, safely protecting the esophageal mucosa during extraction.  Conversely, with a flexible endoscope there is a higher likelihood of esophageal laceration or perforation during extraction of sharp foreign objects.

Otolaryngology – Head and Neck Surgery
Volume 135, Issue 2, Supplement 1, August 2006, Page P219
Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery Foundation, 2006 Official Program