Diagnostic significance of computed tomography findings of foreign body in esophagus

An 84-year-old male with dysphagia was referred to our hospital. Chest computed tomography (CT) showed a rectangular structure along with artificial air in the cervical esophagus. Endoscopy revealed a 'shogi' game piece in the same region shown in CT findings, which was recovered during the endoscopic procedure. From January 2006 to July 2017, we experienced a total of 84 cases of esophageal foreign bodies at our institution (49 males, 35 females; mean age 60 years). Among those cases, the most common foreign body in the esophagus was a food ball, though fish bones and pharmaceutical packaging materials have often been recovered from elderly patients. Chest CT was performed in 39 of those cases prior to an endoscopic examination, with a foreign body in the esophagus detected by CT in 37 (95%). In addition, the stopping portion, progression of inflammation, and presence of free air can be assessed with CT imaging, which provide important clinical information for a safer and faster subsequent endoscopic procedure. Recently, a report conducted outside of Japan noted that eosinophilic esophagitis (EoE) was the main cause of food stoppage in the esophagus. A second-look examination may be necessary to determine the presence of EoE causing such a foreign body blockage.