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)
Investigations to consider
- cardiac biomarkers
- ECG
- CT neck, chest, and/or abdomen
- magnetic resonance imaging (MRI)
- laryngoscopy
- endoscopy
- barium or gastrografin oesophagogram
Treatment algorithm
Contributors
Authors VIEW ALL
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.
Use of this content is subject to our disclaimer