ESOPHAGOTOMY FOR INCARCERATED ESOPHAGEAL FOREIGN-BODIES

Less than 1% of esophageal foreign bodies are irretrievable by endosco pic techniques. Incarcerated esophageal foreign bodies require esophag otomy for removal. A retrospective study was conducted to determine th e incidence, predisposing factors, and optimal treatment of incarcerat ed esophageal foreign bodies. Four of 815 patients (0.5%) with esophag eal foreign bodies required esophagotomy for foreign body removal. Two predisposing factors for incarceration were identified, and these fac tors were related to patient age. Two infants had neglected esophageal foreign bodies that partially migrated through the esophageal wall. I n two adults, foreign body size and sharpness were responsible for inc arceration. One cervical and three thoracic esophagotomies were done. One thoracic esophagotomy suture line dehiscence occurred. Occult fore ign body pressure necrosis may be a factor in esophagotomy suture line leakage. Care is required in esophagotomy closure. Principles establi shed for repair of esophageal perforations are also applicable to esop hagotomy closure.