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Glass and Goodman (1974) have postulated that as Jackson and Jackson succinctly puts it, has not
since the diet of these young patients consisted of given rise to possible complications like ulcerations,
liquid food, it can easily pass through the esophagus fistula and esophageal cicatrical stenosis (Jackson,
even with large foreign bodies. 1950).
THIRD. The only presenting symptom that the SIXTH. The diagnosis of esophageal foreign
patient manifested was prolonged one-month duration bodies is by radiographic studies, first without, then
of cough unrelieved by medications if necessary with a capsule filled with an opaque
substance. If the opaque capsule seems to lodge, the
It may be challenged that the bronchopneumonia patient should have a diagnostic esophagoscopy.
of the patient was secondary to the foreign body.
However, Newman (1978) has showed that this may In conclusion, esophageal foreign bodies may be
be possible. He enumerated the possible pathogenesis overlooked while treating a patient with respiratory
of respiratory symptoms secondary to esophageal symptoms. Some esophageal foreign bodies may
foreign bodies, present with stridor, wheezing, chronic pneumonia,
or may simulate asthma, croup, bronchitis, and bron-
1. compression of the trachea by the posteriorly chopneumonia particularly in children under three
place esophagus years of age. (Newman, 1978). As Jackson has said,
2. aspiration of pooled secretions in the pyriform "failure to consider a foreign body as a diagnostic
.....sinus can occur from esophageal obstruction and lead possibility is one of the commonest causes of its
to pneumonitis or tracheobronchitis; oversight." (Jackson, 1950).
3. long standing esophageal foreign bodies may
produce respiratory symptoms from cricoid perichondritis
or periesophagitis; and REFERENCES:
4. very rarely, the esophageal foreign bodies may
pass through the acquired tracheo-esophageal fistula 1. Nandi P. and Ong G.B (1978) Foreign body in
and obstruct the airway, the esophagus: review of 2394 cases.
Br. J. Surg. C5:5-9.
FOURTH. Although uncommon, sharp and
pointed forcing bodies can be difficult to manage. It 2. Jackson C. and Jackson C.L. (1950) Bronchoeis
important to be careful not to make the situation sophagoscopy. Philadelphia, Saunworse
or to cause a complication, such as a perforated ders.
esophagus. It is always well to remember Jackson's
dictum: "Advancing points puncture, trailing points 3. Bakara A. and Bikhazi G. (1975) Esophageal
do not." foreign bodies. Br. reed. J.I. 561-
563.
__: The open safety pin presents a special problem.
Fortunately for us, Jackson and Jackson have dis- 4. Giordano A., Adams G. Boies L., Meyehoff W.
cussed the various ways of removing an open safety (1981) Current management of esopin,
For the open safety pin with point down, they phageal foreign bodies. Arc Otol
suggest: "the coiled spring is to be sought and, when 107:249-251.
found, seized with the rotation forceps and the esophagoscope
pushed down over it to effect closure." 5. Glass W.M. and Goodman M. (1966) Unsus-
For the open safety pin with point upward, they pected bodies in the young child's
suggested sixteen methods of safe removal (Jackson, esophagus presenting with respiratory
1950). symptoms. Laryngoscope. 76:605.
FIFTH. The presence of granulation tissue 6. Newman D.E. (1978) The radioluscent esophsurrounding
the foreign body suggest that the open ageal foreign body: an often forgotten
safety pin had been in the esophagus for a prolonged cause of respiratory symptoms. J. ped
period of time. It is fortunate for the patient that this 92:1
"prolonged sojourn of foreign body in the esophagus"
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