Foreign Bodies in the Esophagus in a Tertiary Center of Tunisia

Abstract

Introduction: Esophageal foreign body (EFB) ingestion is a frequent medical emergency encountered in otorhinolaryngology, particularly in children and adults with specific risk factors. Prompt diagnosis and timely intervention are essential to prevent potentially life-threatening complications. The objective is to describe the epidemiological, clinical, radiological, and therapeutic characteristics of EFB ingestion and to identify factors associated with delayed consultation and complications.

Methods: A retrospective study was conducted from January 2006 to December 2022, including all patients with EFB ingestion. Clinical, radiological, and therapeutic data were analyzed, with statistical evaluation of factors linked to delayed consultation.

Results: A total of 360 patients were included with an incidence of 15 cases per 1,000 hospitalizations. Children accounted for 52.2% of cases (median age: 5 years), while adults represented 47.8% (median age: 58 years). Most patients (91.8%) presented within 24 hours of ingestion. The upper third of the esophagus was the most frequent site of impaction (86.1%). Esophagoscopy was performed in all patients. Extraction was successful in 93.3% of cases using rigid esophagoscopy. Surgical intervention was required in only 0.8% of cases. Mucosal injury was observed in 11.4% of patients, with major complications (2.2%) including perforation, abscesses, and mediastinitis. Most patients (96.1%) were discharged within 24 hours. Univariate and multivariate analyses identified neuropsychiatric comorbidities, vomiting, sharp-edged objects, and middle esophageal location as factors independently associated with delayed consultation, while food-related foreign bodies and hypersalivation were protective factors.

Conclusion: EFBs represent a common but potentially serious clinical situation. Early diagnosis and management via rigid esophagoscopy yield excellent outcomes. Targeted preventive strategies, particularly education of caregivers and high-risk adult populations, are essential to reduce consultation delays and prevent complications.