Restaurant Patron Suffers Esophageal Damage After Swallowing Foreign Object

Case Overview

This case involves a patron at a restaurant who swallowed a foreign object that accidentally fell into her food. As per the medical records, the patient suffered damage to her esophageal lining, including soft tissue tears along the lining and comorbid infections. An expert in food impactions was sought to discuss the role foreign objects can play in mechanical damage to the esophageal lining and likelihood of such objects precipitating long-term complications.

Questions to the Gastroenterology expert and their responses

Please describe your experience as it pertains to upper and lower GI conditions?

I have 30 years of experience routinely performing upper endoscopies and colonoscopies. I have lectured on foreign bodies and food impactions, and treat such cases fairly frequently. The food impaction patients that I see are primarily individuals who develop meat impactions in the esophagus. Some have pathology in the esophagus that is responsible. Foreign body ingestions usually occur in incarcerated individuals who intentionally ingest dangerous objects in order to have a break from prison routine. Our institution has a contract with the Department of Corrections to assist it in dealing with all their GI problems, including foreign body ingestions. We also have a fair number of psychiatric cases who ingest foreign bodies as suicidal gestures or attempts. I have also published papers on the removal of difficult foreign bodies in the GI tract.

Have you performed procedural interventions (upper endoscopy, sigmoid-/colonoscopy)? Please explain.

I have 30 years of experience routinely performing upper endoscopies and colonoscopies.

Have you ever had a patient develop the complications noted above?

I have had patients who have developed mucosal tears of the esophagus, but none have had serious or long-lasting complications.

About the expert

This expert is board certified in internal medicine and gastroenterology and is currently the Director of the Hepatology section at a major university medical center in the northeast where he is a Professor of Medicine. He was formerly the chief of Gastroenterology-Hepatology and Medical Director of the Endoscopy Unit at University of Connecticut School of Medicine. He began his illustrious career at Albert Einstein School of Medicine where he was awarded a spot in the NIH Medical Scientist Training Program, and completed an MD/PhD. Thereafter, he served a residency in medicine in the Harlem Hospital-Columbia University program. He completed his fellowship training in Gastroenterology and Liver Disease at Albert Einstein College of Medicine. This expert has received many honors including a Fulbright Scholarship. He is extensively published, with over 150 peer-reviewed articles, over 50 book chapters, 11 books, and numerous invitations to present at national and international professional conferences.