Substernal foreign body obstruction and dull pain

Introduction If the foreign body is in the thoracic esophagus, there is no obvious obstruction or only a blockage of the foreign body behind the sternum and pain. Esophageal foreign body often occurs in young children and the elderly lack of teeth, often because of the contents of the mouth to play, eating too fast, swallowing, the old man's false teeth chewed when feeling insensitive, or loosening dentures when sleeping, and swallowed to form esophageal foreign bodies.

Cause

Inadvertently swallowing foreign objects, such as fishbone, bone fragments or fallen dentures, children inadvertently swallow small toys, such as coins, buttons, pins, etc. Foreign bodies are embedded in the narrow part of the esophagus, and the first stenosis is more common.

an examination

Related inspection

Thoracic chest CT examination

Clinical manifestation

1. Difficulty swallowing.

2. Swallowing pain, runny nose, neck and sternal pain.

3. Large foreign bodies can cause difficulty in breathing by pressing the throat or trachea.

4. The neck is swollen and tender.

Differential diagnosis

Differential diagnosis of foreign body obstruction and dull pain after sternum:

1. Post-sternal pain: Post-sternal pain is often seen in the clinic. It refers to the pain between the neck and the lower edge of the thorax (the middle or the lateral side of the chest). The nature of the pain can be various. It is one of the common symptoms, usually from the chest. Caused by diseases (including chest wall disease). After some people have post-sternal pain, they often suspect coronary heart disease and blindly treat them with coronary heart disease. In fact, there are many causes of post-sternal pain. Cardiovascular, pulmonary, mediastinal, esophageal, etc. may be sick. Once the sternal pain occurs, you should go to the hospital as soon as possible, and confirm the diagnosis with clinical symptoms.

2, sternal tenderness: the most obvious part of the sternal tenderness of most patients in the lower part of the sternum, which is equivalent to the sternum of the fourth and fifth intercostal space.

3, post-sternal burning pain: chest pain is a very common clinical symptoms, pain often accompanied by the sternum, pain more when swallowing or making it back, often accompanied by difficulty swallowing. Post-sternal pain is often seen in the clinic. It refers to the pain between the neck and the lower edge of the thorax (the middle or the lateral side of the chest). The nature of the pain can be various. It is one of the common symptoms, usually caused by chest diseases (including chest wall disease). Caused by).

Diagnose based on

1. Have a history of foreign bodies.

2. Swallowing pain and difficulty. Neck, back pain in the sternum.

3. X-ray examination: opaque foreign matter can be seen, light-transparent foreign matter barium meal inspection.

4. Esophagoscopy can confirm the diagnosis.

5. Pay attention to complications such as esophagitis, mediastinal inflammation, mediastinal abscess and major bleeding.

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