Endoscopic Foreign Body Removal

Overview

People sometimes swallow food or foreign bodies that become stuck in the digestive tract. Usually, the items pass through the digestive tract and are excreted from the body in stool. When a foreign object does not pass from the body on its own, you may need a  procedure to remove it.

• What is endoscopic foreign body removal?

  Endoscopic foreign body removal is a minimally invasive procedure to remove items that have been swallowed and become stuck in the digestive tract. (If an object becomes lodged in the airway and obstructs breathing, emergency medical attention is required.)

  A person who swallowed a foreign object may feel that something is stuck in the throat and may have difficulty swallowing. Doctors typically perform an upper endoscopy, also known as an esophagogastroduodenoscopy (EGD), to remove the object.

  During the EGD, the doctor examines the lining of the digestive tract, including the esophagus, stomach and upper part of the small intestine, to check for damage. Learn more about upper endoscopy or EGD.

• Why might I need endoscopic foreign body removal?

  You may need endoscopic foreign body removal if you swallow (ingest) an object, such as a toy, a large pill, battery, or a large piece of food. Often, these items pass through the digestive tract on their own, but sometimes they become stuck. Swallowed foreign objects can cause a blockage, ulceration (sores), or a tear or hole in the lining of the digestive tract.

  Although ingestions can happen to people of any age, they most typically occur with children, especially infants. Commonly swallowed items include:

  • Animal or fish bones in food
  • Batteries
  • Pens or pencils
  • Razor blades
  • Utensils

  Doctors may recommend an X-ray to pinpoint the location of the swallowed object. Items such as bones or pills may not appear on an X-ray. In rare cases, doctors may use a CT scan to locate the object.

  Once doctors have identified and located the object, they will determine the next steps. If food is causing the obstruction, doctors may decide to push it into the stomach. People can typically digest the food, which then pass through the digestive tract on their own.

  Foreign objects that need to be removed include:

  • Anything that gets stuck in the esophagus
  • Batteries, especially disk batteries that can disintegrate when exposed to stomach acid
  • Objects larger than 6 cm (about 2.5 inches)
  • Multiple magnets, which can attract to each other in separate areas of the intestines and cause a tear
  • Pointed or sharp objects such as bones or razor blades
• How do I prepare for endoscopic foreign body removal?

  Because people typically need this procedure in an urgent or emergency situation, no specific preparation is necessary.

  If possible, it helps the care team if you can tell them:

  • What the foreign object is, if you know
  • Whether you have had food or other foreign body obstructions in the past
  • If you have a condition known as eosinophilic esophagitis
• What should I expect during endoscopic foreign body removal?

  To remove a foreign object from the digestive tract, doctors perform an EGD. Before the procedure, you receive a sedative to relax you and make you drowsy. You may fall asleep.

  To perform an EGD, doctors use an endoscope. This long, flexible tube has a lighted camera at its tip and channels for inserting instruments through the scope. The doctor passes the endoscope through the mouth and into the esophagus to see the obstruction.

  Using the instruments, the doctor can remove the foreign body. If the object is in the esophagus and can pass through the body on its own, the doctor may decide to push it into the stomach.

  Learn more about what to expect during an upper endoscopy or EGD.

• What are the possible risks of endoscopic foreign body removal?

  An EGD to remove objects is safe and effective, but any procedure carries a risk of complications. The main risk is a possible tear in the esophagus that may result from removing an item or pushing it into the stomach.

  In rare cases, you may need surgery to remove an object that cannot be removed through EGD.

• Are there other treatments that I can have instead of endoscopic foreign body removal?

  If you have food stuck in your esophagus, the doctor may recommend a medication called glucagon. The medication relaxes the muscles at the end of the esophagus, which may help the food pass into the stomach for digestion. If this is not successful it will need to be removed with an EGD.

Author(s) and Publication Date(s)

Joseph D. Feuerstein, MD, Beth Israel Deaconess Medical Center, Harvard Medical School – Published July 2019.

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