Foreign Body Oesophagus and Differential Diagnosis of Dysphagia: Foreign Body Oesophagus:  One of the commonest emergencies  Most of the time : accidental  Due to negligence  Various objects  If not tackle on time, severe complications  Life threatening. Types of foreign body:  Depends upon age group;  Paediatric : coins, battery, parts of toys  Adult : fish bones, meat bones  Old age: dentures, meat bolus Site of impaction:  Pyriform sinus  Cricopharyngeal junction = 15 cm  Arch of aorta= 23 cm  Left main bronchus= 27 cm Clinical features:  Symptoms : painful swallowing (odynophagia) : Associated symptoms  Signs : tenderness over neck : excessive salivation I/L : pooling of saliva in pyriform sinus Diagnosis:  X-ray soft tissues neck lateral view: : radio-opaque object : increased soft tissues density, prevertebral space  X-ray chest Lateral view:  Ba- swallow  Flexible upper GI-endoscopy  Rigid endoscopy Treatment:  Fresh: rigid oesophagoscopy and removal of foreign body under GA + antibiotic therapy  With infection: IV-Antibiotic therapy for 72 hrs followed by rigid oesophagoscopy  With impaction: thoracotomy and removal of foreign body. Complications:  Trauma : lip------- cardiac sphincter  Perforation of oesophageal wall  Mediastinitis  Haemorrhage  Haemo-pneumothorax  Dislocation of A-O joint. Contraindications:  Severe trismus  Acute oropharyngitis  Acute corrosive burn  Severe cervical spondylosis  Fracture of cervical spine  Secondaries in cervical spine  Aortic aneurism  Vascular tumour Causes of Dysphagia: 1. Congenital: stricture, atresia, web 2. F.B oesophagus 3. Neoplastic : in the lumen: pharynx, oesophagus : outside the wall: thyroid, larynx, bronchus, neck nodes 1. Paralytic: head injury, # base of skull, CVA, encephalitis, myasthenia , LMND, PBP