Last reviewed: November 2017
Last updated: January  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • dysphagia
  • non-specific abdominal pain
  • stridor and wheezing
  • drooling

Other diagnostic factors

  • gagging, nausea/vomiting, neck/throat pain
  • atypical chest pain or non-cardiac chest pain
  • choking
  • signs of upper GI obstruction
  • lower GI bleeding
  • odynophagia
  • fever, poor feeding, failure to thrive, and irritability (in children)
  • acute or chronic asthma-like symptoms or recurrent pneumonias
  • signs of sepsis
  • sign of acute drug intoxication

Risk factors

  • age <15 years
  • male sex (adults)
  • GI tract narrowing
  • mechanical disorders of the GI tract
  • chemical dependence
  • seizure disorder
  • intellectual disability
  • mental illness
  • inmates or people engaged in criminal activities
  • dental disorders
  • hurried eating
  • impaired gag reflex
  • hx of underlying oesophageal disease, surgery, or procedure

Diagnostic investigations

1st investigations to order

  • x-rays of neck, chest, abdomen
  • FBC
  • urea and electrolytes
  • PT/INR
  • PTT
  • oxygen saturation
  • faecal occult blood testing
  • hand-held metal detector (HHMD)
Full details

Investigations to consider

  • cardiac biomarkers
  • ECG
  • CT neck, chest, and/or abdomen
  • magnetic resonance imaging (MRI)
  • laryngoscopy
  • endoscopy
  • barium or gastrografin oesophagogram
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Juan Carlos Munoz

Associate Professor of Medicine

Borland Groover Clinic

Jacksonville

FL

Disclosures

JCM declares that he has no competing interests.

Professor Juan Carlos Munoz would like to gratefully acknowledge Professor Luis F. Laos, a previous contributor to this monograph. LFL declares that he has no competing interests.

Peer reviewers VIEW ALL

Consultant

Ganesh Man Singh Memorial Academy of ENT and Head and Neck Studies

TU Teaching Hospital

Maharajgunj

Kathmandu

Nepal

Disclosures

PA declares that he has no competing interests.

General Surgery Chief Resident

Department of General Surgery

University of Tennessee Medical Center

Knoxville

TN

Disclosures

JFA declares that he has no competing interests.

Clinical Research Fellow

Cleveland Clinic Florida

Weston

FL

Disclosures

RVS declares that he has no competing interests.

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

PA

Disclosures

DJH declares that he has no competing interests.

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