What is a Mallory-Weiss tear. How is it caused. What are the symptoms of a Mallory-Weiss tear. How is it diagnosed and treated. What complications can arise from a Mallory-Weiss tear. Can it be prevented. When should you seek medical attention for a Mallory-Weiss tear.

Understanding Mallory-Weiss Tears: A Comprehensive Overview

A Mallory-Weiss tear is a condition that affects the lower esophagus, the tube connecting the throat to the stomach. This tear occurs in the mucous membrane, often due to forceful vomiting or coughing. While it may sound alarming, understanding its causes, symptoms, and treatment options can help you navigate this condition more effectively.

What Exactly is a Mallory-Weiss Tear?

A Mallory-Weiss tear is a longitudinal laceration in the mucosa at the gastroesophageal junction or in the cardiac portion of the stomach. It typically occurs when there is a sudden increase in intra-abdominal pressure, which can be caused by various factors.

Common Causes and Risk Factors of Mallory-Weiss Tears

The primary causes of Mallory-Weiss tears are often related to actions that increase pressure in the abdominal area. These include:

• Violent coughing
• Severe vomiting
• Hiatal hernia
• Childbirth
• Excessive alcohol consumption

Alcohol consumption is particularly noteworthy as it can lead to both vomiting and a weakening of the esophageal lining, increasing the risk of a tear.

Are Certain Individuals More at Risk?

While anyone can experience a Mallory-Weiss tear, certain factors may increase the likelihood:

• Chronic alcoholism
• Bulimia nervosa
• Pregnancy
• Conditions that cause frequent coughing, such as chronic bronchitis

Recognizing the Symptoms of a Mallory-Weiss Tear

Identifying a Mallory-Weiss tear can be challenging as the symptoms may not always be immediately apparent. However, there are several key indicators to watch for:

• Hematemesis (vomiting blood)
• Melena (black, tar-like stools)
• Hematochezia (bright red blood in stools)
• Weakness or dizziness
• Shortness of breath
• Abdominal or chest pain, sometimes radiating to the back
• Paleness
• Rapid heartbeat

It’s important to note that the severity of symptoms can vary greatly depending on the extent of the tear and the amount of bleeding.

How Quickly Do Symptoms Typically Appear?

Symptoms of a Mallory-Weiss tear usually manifest shortly after the triggering event, such as severe vomiting or coughing. However, in some cases, the onset of symptoms may be delayed, making it crucial to remain vigilant if you’ve experienced any potential causes.

Diagnostic Procedures for Mallory-Weiss Tears

Accurately diagnosing a Mallory-Weiss tear requires a combination of clinical evaluation and specific diagnostic procedures. The most common methods include:

1. Physical examination and medical history review
2. Stool sample analysis to check for the presence of blood
3. Upper endoscopy (esophagogastroduodenoscopy or EGD)
4. Blood tests to assess hemoglobin levels and coagulation factors

What is an Upper Endoscopy and How is it Performed?

An upper endoscopy is a procedure where a thin, flexible tube with a camera (endoscope) is inserted through the mouth and guided down the esophagus. This allows the healthcare provider to visualize the esophagus, stomach, and upper part of the small intestine, identifying any tears or sources of bleeding. The procedure is typically performed under sedation to ensure patient comfort.

Treatment Options for Mallory-Weiss Tears

The treatment approach for Mallory-Weiss tears depends on the severity of the condition and the extent of bleeding. In many cases, these tears heal on their own without specific intervention. However, when treatment is necessary, options may include:

• Endoscopic interventions:
  • Injection therapy with epinephrine or sclerosing agents
  • Thermal coagulation
  • Clip placement to close the tear
• Medication:
  • Proton pump inhibitors to reduce stomach acid
  • Antacids to promote healing
• Blood transfusions in cases of significant blood loss
• Rarely, surgical intervention for severe, uncontrolled bleeding

How Effective are Endoscopic Treatments?

Endoscopic treatments have shown high success rates in managing Mallory-Weiss tears. Studies indicate that endoscopic interventions can achieve hemostasis (stopping of bleeding) in over 90% of cases, with a low rate of rebleeding. The choice of specific endoscopic technique often depends on the characteristics of the tear and the expertise of the endoscopist.

Potential Complications and Long-Term Outlook

While most Mallory-Weiss tears heal without significant complications, it’s important to be aware of potential risks:

• Severe blood loss leading to anemia
• Hypovolemic shock in cases of massive bleeding
• Recurrence of the tear
• Esophageal perforation (rare)

The long-term prognosis for most patients with Mallory-Weiss tears is generally good, with most experiencing a full recovery within a few days to weeks.

What Factors Influence Recovery Time?

Several factors can affect the recovery time from a Mallory-Weiss tear:

• The size and depth of the tear
• The patient’s overall health and immune status
• Adherence to treatment recommendations
• Presence of underlying conditions that may impair healing

Preventive Measures and Lifestyle Modifications

While it’s not always possible to prevent Mallory-Weiss tears, certain lifestyle changes can help reduce the risk:

• Moderating alcohol consumption
• Quitting smoking to reduce coughing
• Managing conditions that cause frequent vomiting or coughing
• Practicing stress-reduction techniques
• Maintaining a healthy diet to prevent acid reflux

Can Dietary Changes Help Prevent Mallory-Weiss Tears?

While diet alone cannot prevent Mallory-Weiss tears, certain dietary modifications may help reduce the risk of conditions that can lead to tears:

• Avoiding trigger foods that cause acid reflux
• Eating smaller, more frequent meals
• Staying hydrated to prevent constipation and straining
• Limiting spicy and acidic foods

When to Seek Medical Attention

Recognizing when to seek medical help is crucial in managing Mallory-Weiss tears effectively. You should contact your healthcare provider immediately if you experience:

• Vomiting blood or material that looks like coffee grounds
• Black, tarry stools or bright red blood in stools
• Severe abdominal or chest pain
• Dizziness, weakness, or fainting
• Rapid heartbeat or difficulty breathing

What Information Should You Provide to Your Healthcare Provider?

When seeking medical attention for a suspected Mallory-Weiss tear, be prepared to provide the following information:

• A detailed description of your symptoms and when they started
• Any recent episodes of severe vomiting or coughing
• Your medical history, including any chronic conditions
• A list of current medications, including over-the-counter drugs and supplements
• Any recent changes in diet or alcohol consumption

By providing comprehensive information, you can help your healthcare provider make an accurate diagnosis and develop an appropriate treatment plan.

Advances in Research and Future Directions

Ongoing research in the field of gastroenterology continues to improve our understanding and management of Mallory-Weiss tears. Some areas of current interest include:

• Development of novel endoscopic techniques for more effective hemostasis
• Investigation of biomarkers to predict the risk of rebleeding
• Exploration of minimally invasive surgical approaches for complex cases
• Studies on the long-term outcomes of different treatment modalities

How Might Future Treatments Differ from Current Approaches?

Future treatments for Mallory-Weiss tears may involve more personalized approaches based on individual patient characteristics and tear patterns. Potential advancements could include:

• Targeted biological therapies to promote faster healing
• Advanced imaging techniques for more precise diagnosis and treatment planning
• Robotic-assisted endoscopic procedures for improved precision
• Development of novel hemostatic agents with enhanced efficacy and safety profiles

As research progresses, these innovations may lead to more effective treatments with fewer complications and shorter recovery times.

Living with and Managing Mallory-Weiss Tears

For individuals who have experienced a Mallory-Weiss tear, managing the condition and preventing recurrence is crucial. This often involves a combination of medical guidance and lifestyle adjustments:

• Following up regularly with your healthcare provider
• Adhering to prescribed medications and treatment plans
• Monitoring for any signs of recurrence or complications
• Implementing stress management techniques
• Making dietary modifications to reduce the risk of triggering events

What Support Resources are Available for Patients?

Several resources can provide support and information for individuals dealing with Mallory-Weiss tears:

• Gastroenterology patient support groups
• Online forums and communities for sharing experiences
• Educational materials from reputable medical organizations
• Nutritional counseling services
• Mental health support for managing stress and anxiety related to the condition

Utilizing these resources can help patients better understand their condition, cope with its impacts, and maintain a good quality of life.

Mallory-Weiss Tear | Cedars-Sinai

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What is a Mallory-Weiss tear?

Your
esophagus is the tube that carries food from your throat to your stomach. It plays
a
vital role in digestion. Sometimes, violent coughing or vomiting can tear the tissue
of
your lower esophagus and it can start to bleed. The condition is called a Mallory-Weiss
tear.

What causes a Mallory-Weiss tear?

A
Mallory-Weiss tear is most often caused from violent coughing or vomiting. Less common
causes are a hiatal hernia or childbirth, which can increase pressure in your abdomen.
Drinking alcohol can make vomiting and a tear more likely.

What are the symptoms of a Mallory-Weiss tear?

It
can be hard to tell that you have a Mallory-Weiss tear and that you are bleeding inside.
But you may have some of these symptoms:

• Vomit that is bright red or that looks like coffee grounds
• Black or tar-like stools
• Stools
  with blood in them
• Weakness, dizziness, faintness
• Shortness of breath
• Diarrhea
• Paleness
• Abdominal or chest pain that sometimes goes to your back

How is a Mallory-Weiss tear diagnosed?

If
you have symptoms of a Mallory-Weiss tear, your healthcare provider may check your
stool
for blood. Your healthcare provider may also do an endoscopy. For this test, a flexible
tube is put in through your mouth and down into your esophagus. A camera at the end
of
the tube lets the healthcare provider see the tear inside your esophagus.

How is a Mallory-Weiss tear treated?

A
Mallory-Weiss tear will stop bleeding and begin to heal on its own in most cases.
Sometimes you will need treatment. If treatment is needed, an endoscope may be used
to
give you an injection or a heat treatment to stop the bleeding. Or it may be used
to
insert a clip that closes the tear and stops the bleeding. Often, your healthcare
provider will also prescribe medicines to lower stomach acid and help with healing.
If
you are on blood thinning medicine, check with your healthcare provider about when
you
should stop and restart the blood thinner.

What are possible complications of
a Mallory-Weiss tear?

In
rare cases, a Mallory-Weiss tear leads to severe internal bleeding. You get a rapid
pulse, a drop in blood pressure, trouble producing urine, and shock. If mild bleeding
goes untreated, it may result in anemia with fatigue, and shortness of breath.

Can a Mallory-Weiss tear be prevented?

There isn’t a lot you can do to prevent a Mallory-Weiss tear. Staying away from
situations that cause violent vomiting, such as drinking too much alcohol, or coughing,
such as smoking, can help lessen your risk.

When should I call my healthcare provider?

Blood in your vomit or stool is a serious symptom that calls for urgent medical help.
If you notice any of the symptoms of a Mallory-Weiss tear, call your healthcare provider
right away.

Key points about a Mallory-Weiss
tear

• A Mallory-Weiss tear is a tear of the tissue of your lower esophagus.
• It is most often caused by violent coughing or vomiting.
• A Mallory-Weiss tear can be diagnosed and treated during an endoscopic procedure.
• If the tear is not treated, it can lead to anemia, fatigue, shortness of breath, and
  even shock.

Next steps

Tips to help you get the most from a visit to your health care
provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember
  what your provider tells you.
• At the visit, write down the name of a new diagnosis and any new
  medicines, treatments, or tests. Also write down any new instructions your provider
  gives you.
• Know why a new medicine or treatment is prescribed and how it
  will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results
  could mean.
• Know what to expect if you do not take the medicine or have the
  test or procedure.
• If you have a follow-up appointment, write down the date, time,
  and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Jen Lehrer MD

Medical Reviewer: Ronald Karlin MD

Medical Reviewer: Raymond Kent Turley BSN MSN RN

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Food Stuck in Throat When You Can Still Breathe

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If food gets stuck in your throat, but you aren’t choking, home remedies, including drinking a carbonated beverage, may help. But if you have severe symptoms like difficulty breathing, you may need medical attention.

Swallowing is a complex process. When you eat, around 50 pairs of muscles and many nerves work together to move food from your mouth to your stomach. It’s not uncommon for something to go wrong during this process, making it feel like you have food stuck in your throat.

When you take a bite of solid food, a three-step process begins:

1. You prepare the food to be swallowed by chewing it. This process allows the food to mix with saliva, and transforms it into a moistened puree.
2. Your swallowing reflex is triggered as your tongue pushes the food to the back of your throat. During this phase, your windpipe closes tightly and your breathing stops. This prevents food from going down the wrong pipe.
3. The food enters your esophagus and travels down into your stomach.

When it feels like something didn’t go all the way down, it’s usually because it’s stuck in your esophagus. Your breathing isn’t affected when this happens because the food has already cleared your windpipe. However, you may cough or gag.

Symptoms of food stuck in your esophagus develop immediately after it happens. It’s not uncommon to have severe chest pain. You may also experience excessive drooling. But there are often ways to resolve the issue at home.

Thousands of people die from choking every year. It’s particularly common among young children and adults over the age of 74. Choking happens when food or a foreign object gets stuck in your throat or windpipe, blocking the flow of air.

When someone is choking, they:

• are unable to talk
• have difficulty breathing or noisy breathing
• make squeaky sounds when trying to breathe
• cough, forcefully or weakly
• become flushed, then turn pale or bluish
• lose consciousness

Choking is a life-threatening emergency. If you or a loved one experiences these symptoms, call your local emergency services and perform rescue techniques such as the Heimlich maneuver or chest compressions immediately.

The following techniques may assist you in removing food that’s become lodged in your esophagus.

The ‘Coca-Cola’ trick

Research suggests that drinking a can of Coke, or another carbonated beverage, can help dislodge food stuck in the esophagus. Doctors and emergency workers often utilize this simple technique to break up food.

Although they don’t know exactly how it works, doctors believe that the carbon dioxide gas in soda helps disintegrate the food. It’s also thought that some of the soda gets into the stomach, which then releases gas. The pressure of the gas can dislodge the stuck food.

Try a few cans of diet soda or seltzer water at home immediately after noticing the stuck food.

Purchase seltzer water online.

Simethicone

Over-the-counter medications designed to treat gas pain may help dislodge food stuck in the esophagus. In the same way as carbonated sodas, medications containing simethicone (Gas-X) make it easier for your stomach to produce gas. This gas increases the pressure in your esophagus and can push the food loose.

Follow the standard dosing recommendation on the package.

Shop for simethicone medications.

Water

A few big sips of water may help you wash down the food stuck in your esophagus. Normally, your saliva provides enough lubrication to help food slide easily down the esophagus. If your food wasn’t chewed properly, it may be too dry. Repeated sips of water may moisten the stuck food, making it go down more easily.

A moist piece of food

It may feel uncomfortable to swallow something else, but sometimes one food can help push another down. Try dipping a piece of bread in some water or milk to soften it, and take a few small bites.

Another effective option may be to take a bite of banana, a naturally soft food.

Alka-Seltzer or baking soda

An effervescent drug like Alka-Seltzer may help break down food that’s stuck in the throat. Effervescent drugs dissolve when mixed with a liquid. Similar to soda, the bubbles they produce when dissolving may help disintegrate the food and produce pressure that can dislodge it.

Find Alka-Seltzer online.

If you don’t have Alka-Seltzer, you can try mixing some baking soda (sodium bicarbonate), with water. This may help dislodge food in the same way.

Shop for sodium bicarbonate.

Butter

Sometimes the esophagus needs an extra bit of lubrication. As unpleasant as it may sound, it may help to eat a tablespoon of butter. This can sometimes help moisten the lining of the esophagus and make it easier for the stuck food to move down into your stomach.

Wait it out

Food that gets stuck in the throat usually passes on its own, given some time. Give your body a chance to do its thing.

If you’re unable to swallow your saliva and are experiencing distress, go to your local emergency room as soon as possible. If you’re not in distress but the food is still stuck, you can have an endoscopic procedure to remove the food within 24 hours. After that, there’s risk of damage to the lining of your esophagus. Some doctors recommend coming in after 6 to 12 hours to reduce the likelihood of damage and make the extraction easier.

During an endoscopic procedure, your doctor can identify any possible underlying causes. If you frequently get food stuck in your throat, you should consult a doctor. One of the most common problems is a narrowing of the esophagus caused by the buildup of scar tissue, or esophageal stricture. A specialist can treat esophageal stricture by placing a stent or performing a dilation procedure.

Getting food stuck in your throat can be frustrating and painful. If this occurs frequently, talk to your doctor about possible underlying causes. Otherwise, you may be able to avoid a trip to the emergency room by treating yourself at home with carbonated beverages or other remedies.

In the future, be particularly careful when eating meat, as it’s the most common culprit. Avoid eating too quickly, take small bites, and avoid eating while intoxicated.

WHAT TO DO IF A PERSON CHOKES OR SWALLOWS AN INEDIBLE OBJECT

Dr. Evgeny Mitin again rushes to the rescue: now to those who suddenly choked or ate something that is not supposed to be. What to do if a person suddenly swallowed a pin, a needle, a toothpick, a match, a spoon and even a fork? How to help someone who is choking? And is it worth it in such cases to slap on the back, as we used to? Evgeny Mitin, an ambulance doctor at the BMC UDP RK, gives the most necessary advice.

IF YOU SWALLOWED INEDIBLE

Let’s start with foreign objects, which sometimes, in unforeseen situations, end up in our stomach, throat or upper respiratory tract: they are called foreign bodies in professional language.

A foreign body is an object that should not be in the body. This includes household items (spoons, forks, pens, caps), injuring agents (needles, knives, bullets). They can enter the body through the skin or through natural openings.

But now we will talk about foreign bodies that enter the upper respiratory tract and pharynx, which most often happens not intentionally, but accidentally, through negligence, during a game, laughter, coughing, or fright.

WHAT YOU CAN SWALLOW

Anything. Pins, coins, needles can be in our body: very often women, sewing on something or darning, place a needle between their lips and then, while sneezing or laughing, they also accidentally swallow it. Or we hold matches and toothpicks in our teeth during active conversation, which can be swallowed during coughing and fright. Small children like to put in their mouth what they find on the floor – small toys, coins.

All these items, if they are small, can get into the esophagus, go into the stomach and then into the intestines. But the route may be different: a foreign body sometimes gets into the larynx, pharynx and trachea, and even, there have been cases, it can reach the bronchi. It all depends on the size. If the swallowed object is quite large, then it usually gets stuck at the level of the pharynx and trachea, blocking breathing. Therefore, some manufacturers of household appliances pay special attention to this.

For example, you know that ballpoint pen caps are now made in such a way that there is a gap in them – the space between the clothespin of a ballpoint pen cap and the cap itself. If you swallow it, then the air will still enter the lungs through this lumen. You also probably noticed that there is also a hole at the tip of the cap, which is able to let in enough air so that the person does not completely suffocate.

WHAT TO DO

Sometimes small foreign objects, when swallowed, smoothly enter the esophagus and stomach, or, as often happens with young children, others can see that the child was playing, holding some object in his mouth, and he suddenly disappeared. In both cases, you need to go to the doctor, examine the stomach and esophagus. If possible, foreign bodies are removed in such cases. If the object has gone quite deep, and in principle it does not pose a big threat to health, then you can wait until it comes out naturally. If this does not happen, then the foreign body is removed surgically.

But what if a foreign body is stuck in the throat?

The upper respiratory tract has its own peculiarity: when a foreign object enters the glottis, it can close and pinch it. Such a physiological reaction is called laryngospasm: the body, as they say, catches a foreign object, does not allow it to pass further. But sometimes it slips past the vocal cords, enters the trachea, and begins to move on inhalation and exhalation. At the same time, it becomes difficult for a person to breathe: an incessant cough begins, and a spasm in the larynx leads to respiratory failure. In this case, you can not hesitate.

In order to provide first aid when a foreign body enters the pharynx, larynx, upper respiratory tract, you need to apply the Heimlich maneuver.

1. The victim should be turned with his back and tightly wrapped around his hands between the navel and the upper half of the abdomen.

2. With a sharp movement from the bottom up, you need to press several times on the indicated area. Thus, the volume of the chest is reduced, as a result of which the foreign body can fly into the oral cavity.

It is important to act carefully and immediately remove the object from the mouth, because it can get back inside: the first thing the victim wants to do in such a situation is to inhale as much air as possible.

If the person is unconscious, care should be taken in the supine position as follows:

1. sit down on the victim’s feet

2. with both hands we press on the same area – between the navel and the upper half of the abdomen from the bottom up

3. make several sharp pushes.

Also, a person who has lost consciousness due to respiratory failure may develop heart failure, that is, cardiac arrest.

In such cases, it is necessary to proceed immediately to compressions on the heart, since it is necessary to restore blood circulation and prevent the brain from dying.

In children foreign bodies are removed as follows:

1. put the child on the forearm face in the palm

2. put two fingers of the brush in his mouth

3. With jerky movements between the shoulder blades, we apply light blows.

IS IT WORTH A PAP ON THE BACK

If the object is stuck in the upper respiratory tract, then hitting the back is useless, since our efforts will not set the desired impulse. When hit, as a rule, the object bounces towards the impact, not up.

There are also cases when a foreign body passes the pharynx and gets stuck in the esophagus. This phenomenon is called cardiospasm: a large poorly chewed food lump gets stuck in the cardia – the first section of the esophagus, which is located at the level of the heart. Vomiting reactions are usually not able to push the piece up, as it is too tightly covered, it is impossible to swallow it further, while it becomes difficult for a person to breathe, because the lump squeezes the trachea. All this causes not only suffocation: the victim simply begins to panic, because he can neither swallow nor push the piece out. In such cases, we can only help with medicine by introducing atropine. This is a medication that relaxes the muscles of the esophagus and allows stuck food to pass further into the stomach.

For this person, you need to urgently take to the hospital, or call an ambulance. The earlier the better.

THAT DOESN’T HAPPEN

It is important to always remember the rule that we were told from childhood at the table “when I eat, I am deaf and dumb”, so as not to choke and avoid getting a piece of food, fruit seeds and jam in the wrong place. You also need to get rid of bad habits, for example, keep foreign objects in your mouth – toothpicks, pins, paper clips, needles, caps, otherwise someday in an unforeseen situation they may go further than they should.

Foreign bodies of the laryngopharynx. Symptoms and complications. Extraction of a foreign body from the laryngopharynx

Varieties of foreign bodies of the laryngopharynx

There are exogenous and endogenous foreign bodies of the laryngopharynx. The first group is foreign bodies that have entered the throat from the outside. They are the most common. The second group consists of foreign bodies that form in the pharynx itself. These include tonsil stones, which are very rare. Foreign bodies often get into the throat with food (fish and meat bones, glass fragments, pieces of wire and wood, pieces of meat, cereal grains, etc.)

Foreign bodies can also be objects that accidentally get into the mouth (nails, buttons, pins, sewing and medical needles, hooks, small parts of toys), as well as dentures. Live foreign bodies are also observed. In countries with a hot climate, and in our country in the republics of Central Asia and Transcaucasia, there are leeches that can penetrate into the oral cavity when drinking water from a stream, ditches, while bathing.

Sharp and small foreign bodies (usually fish bones) get stuck in the oropharynx, penetrating into the lacunae of the palatine tonsils, arches, lingual tonsil, valleculae. Large foreign bodies (buttons, coins, pieces of unchewed food, dentures, large meat bones) stop in the laryngopharynx above the entrance to the esophagus or in the pear-shaped pocket. Foreign bodies in the nasopharynx are much less common. They get into it with injuries to the nose and paranasal sinuses, vomiting, during medical procedures, and also when trying to remove a foreign body from the lower pharynx.

Symptoms of a hypopharyngeal foreign body

Clinical symptoms due to the presence of a hypopharyngeal foreign body depend on its size, shape, site of introduction and duration of stay. The main symptoms are sore throat, aggravated by swallowing, sensation of a foreign object. Difficulty in swallowing food, salivation are noted. Large foreign bodies stuck in the lower part of the pharynx disrupt speech, cause coughing and severe shortness of breath.

An inflammatory process occurs at the location of the foreign body in the wall of the pharynx, as a result of which the pain sensations intensify. Often, a foreign body that has passed into the esophagus and stomach injures the mucous membrane of the pharynx, which can cause symptoms of an “imaginary” foreign body. The sensation of a foreign body may be associated with chronic inflammatory processes and tumors of the pharynx, paresthesia, elongation of the styloid process, deforming spondylosis of the cervical spine, osteophytes of the cervical vertebrae, and pharyngeal-esophageal-cervical syndrome. The special suspiciousness of the patient also matters.

Complications of a foreign body in the laryngopharynx

A foreign body in the pharynx, injuring the mucous membrane and submucosal layer, can cause a number of complications: abscesses of the pharynx (retropharyngeal, lateropharyngeal) and tonsils, submandibular lymphadenitis, neck phlegmon, bleeding, subcutaneous emphysema. Perhaps the development of mediastinitis, sepsis, damage to the cervical vertebrae.

Diagnosis of a foreign body in the laryngopharynx

The diagnosis of a foreign body in the pharynx is established on the basis of the patient’s complaints, anamnesis data and the results of objective studies: mesopharyngoscopy, posterior rhinoscopy, indirect and direct laryngoscopy. The patient’s indication of pain when swallowing in a certain place facilitates the identification of a foreign body. Examination of the pharynx should be thorough, especially carefully you need to examine the places of the “favorite” localization of foreign bodies: palatine tonsils, arches, vallecules, pear-shaped pockets.

If there is a suspicion that a foreign body is in the palatine tonsil, it is necessary to slightly dislocate it by pushing the anterior palatoglossal arch with a spatula and carefully examine the lacunae. Inspection of the pharynx is best done under local terminal anesthesia. In the diagnosis of foreign bodies, especially metallic ones, it is advisable to conduct a survey radiography of the pharynx in two projections.