From the Guidelines
The most common impacted foreign object in the esophagus is food bolus (option 3). This is based on the general understanding of esophageal foreign body impactions, although the provided study does not specifically quantify the incidence of different types of foreign bodies 1.
Key Points to Consider:
- Esophageal foreign body ingestion is a common issue, with over 100,000 cases per year in the USA, as reported by the study 1.
- The study highlights that accidental ingestion of various objects, including coins, batteries, toys, and magnets, is common in children, while adults may ingest foreign bodies due to intoxication or cognitive impairment 1.
- However, the study does not provide specific data on the most common type of impacted foreign object in the esophagus, but it does discuss the anatomical and physiological reasons for impaction, such as the size and shape of the foreign body and the presence of anatomical narrowings like the cricopharyngeus and aortic arch 1.
Clinical Presentation and Management:
- The clinical presentation of esophageal foreign body impaction typically includes acute onset of dysphagia, odynophagia, neck tenderness, and retrosternal pain, as described in the study 1.
- Management of esophageal foreign body impaction depends on the type and location of the foreign body, as well as the patient's symptoms and underlying medical conditions.
- While the study does not provide specific guidance on the management of food bolus impactions, it emphasizes the importance of prompt recognition and treatment of esophageal foreign body ingestion to prevent complications like airway obstruction, aspiration, and tissue damage 1.
From the Research
Common Impacted Foreign Objects in the Esophagus
The most common impacted foreign objects in the esophagus can be identified through various studies, including:
- Food bolus, which is a common cause of esophageal foreign body obstruction in adults, often due to meat bolus impaction above a pre-existing distal esophageal ring, peptic or malignant esophageal stricture, or eosinophilic esophagitis 2
- Bones, such as chicken bones and fish bones, which have been reported in several cases of foreign body removal from the upper gastrointestinal tract 3
- Other foreign objects, including denture prosthesis, long pins, and press-through packages, which have also been reported in cases of foreign body ingestion 3
Comparison of Options
Comparing the given options:
- Food bolus (option 3) is a common cause of esophageal foreign body obstruction in adults 2
- Bones (option 1) are also a common type of foreign body encountered in the esophagus, particularly in the adult population 3, 4
- Dentures (option 2) have been reported in some cases, but are less common than food bolus or bones 3
- Bluetooth batteries (option 4) are not mentioned in the provided studies as a common impacted foreign object in the esophagus
Evidence Summary
Based on the provided evidence, food bolus (option 3) and bones (option 1) are the most common impacted foreign objects in the esophagus, with food bolus being a common cause of esophageal foreign body obstruction in adults 5, 2, 6, 4.