Esophageal foreign bodies can lead to impaction, perforation, or strictures and can be life-threatening in the case of button battery ingestion. The characteristics of esophageal foreign body ingestion vary with the patient's age. In children, coins, toys, and food are the most commonly ingested foreign bodies. After childhood, impacted food bolus is the most common cause of an esophageal foreign body.

Anatomically, the narrowest parts of the esophagus are the cricopharyngeus muscle (C6 vertebra), where the aorta crosses over the esophagus, and at the lower esophageal sphincter. These are the areas where a foreign body is most likely to become lodged.

An especially worrisome object to have ingested is a button battery. Button batteries cause severe alkaline caustic injuries when lodged in the esophagus. This can lead to rapid tissue necrosis and perforation and can be fatal if not rapidly managed.

Signs of a high-grade obstruction include drooling, retching, or, less commonly, respiratory distress (from external compression of the trachea). Other common symptoms that may portent a partial obstruction include dysphagia, odynophagia, or retrosternal chest pain.

Some populations, such as patients with psychiatric disorders or prisoners, may recurrently ingest foreign bodies as a manifestation of their psychiatric disease or for secondary gain. Additionally, people who ingest large packets of drugs (body stuffing) are at risk of impaction in the esophagus.

An anatomic abnormality will be found in up to 88% of patients that have an impacted food bolus.

Related topics: foreign body aspiration, upper airway obstruction