Internal Medicine

Endoscopy Foreign Body Removal (Esophageal, Airway, Gastric)

Unfortunately, dogs will commonly ingest foreign bodies which can become lodged in the airway, esophagus, or stomach. Some of these foreign bodies may pass and become stuck in the small intestines as well. This can be life-threatening.

Airway foreign bodies:

Uncommonly, dogs can inhale foreign bodies that may become stuck in their nose or lungs. Nasal foreign bodies can be difficult to diagnose. Rhinoscopy (evaluation of the nasal cavity with a camera) can be used. It is especially important to look at the back of the nasal cavity (called nasopharyngeal area). Cats can also vomit hairballs or other objects that may become lodged in this area. Additionally, foreign bodies can be inhaled and go directly to the lungs. The most common culprit is grass awns. These foreign bodies are most likely successfully removed when diagnosed early on. Over time, excessive mucus secretion will "hide" foreign objects in the airways. At this point, these foreign objects are only able to be removed via thoracic surgery after being identified via CT scan. Occasionally, dogs and cats can inhale foreign objects into their lungs and develop significant respiratory distress. These cases are considered emergencies and should be addressed as soon as possible.

Esophageal foreign bodies:

Esophageal foreign bodies are considered an emergency because the foreign body will cause significant damage to the esophagus over time. Very serious damage can occur within hours depending on the foreign body composition, its size, size of patient, and location lodged.
Side-effects of esophageal foreign bodies include severe esophagitis, perforation of the esophagus and development of esophageal strictures in the future.
Esophageal strictures lead to the inability to eat because food often times does not pass through the stricture site. Decreased appetite and regurgitation as well as retching and excessive salivation are common clinical signs. Treatment of this complication is esophageal stricture ballooning, which is laborious and often times unsuccessful. Surgery is recommended in cases where the foreign body is not able to be removed endoscopically. This is considered the last resort because thoracic surgery is necessary and subsequent esophageal stricture is common. 

Gastric foreign bodies:

Removal of gastric foreign bodies is not as urgent as esophageal foreign bodies. However, gastric foreign bodies can cause significant damage to the stomach lining, systemic illness such as breakdown of red blood cells (penny ingestion) or toxin absorption, as well as obstruction of the gastrointestinal tract. Abdominal surgery is required once the intestines become obstructed.