On the Bleeding Edge: Mastering GI Emergencies and Inpatient GI Consultation (On-Demand) | 2026-The Difficult Food Bolus & Foreign Bodies

Video Transcription

Video Summary

The lecture reviews management of esophageal food impactions and gastrointestinal foreign bodies. Take a careful history, including ingestion time, anticoagulants, prior surgery, co-ingestions, and possible self-harm. Patient-reported location below the upper esophageal sphincter is unreliable. Use at least two-view radiographs when appropriate, but remember that objects such as chicken bones may be radiolucent; CT may be needed.<br /><br />Food impaction with inability to manage secretions is an emergency because of aspiration and pressure-related injury; arrange prompt endoscopy. Patients who can handle secretions may sometimes wait until morning. Keep patients NPO and avoid repeated oral trials. Preparation, an experienced team, and suitable retrieval or suction tools improve success.<br /><br />Investigate why impaction occurred, including biopsies for eosinophilic esophagitis even when the esophagus looks normal, and arrange follow-up. Objects longer than 6 cm or wider than 2.5 cm are unlikely to pass and often require removal. After an object passes beyond endoscopic reach, assess for complications and object-related risk; observe high-risk sharp objects closely, with surgery for complications or failure to progress.<br /><br />For sharp-object retrieval, protect the bowel and instrument, and orient the sharp edge trailing. Rectal foreign bodies can be difficult; avoid unsafe examination and involve surgical colleagues early. Drug-packet removal is case-specific and carries rupture risk.

Asset Subtitle

Michelle Hughes, MD

Keywords

esophageal food impaction

gastrointestinal foreign bodies

endoscopy

aspiration risk

eosinophilic esophagitis

sharp object retrieval

rectal foreign bodies

emergency endoscopy

radiolucent objects

sharp-object retrieval