Ingested foreign Body


  • Usually children under 5 yrs or adults with intellectual impairment or DSH
  • Impact in oesophagus at:
    • cricopharyngeus (C6)
    • aortic arch (T4) and
    • OG sphincter (T11)
  • Pylorus of stomach
  • Duodenum
  • Ileocaecal valve (rarely at colonic flexures)

In general

  • If an FB passes cricopharyngeus (C6) [narrowest part of GI tract], excellent chance it will pass the rest of the tract
  • Fish bones usually scratch the mucosa, occasionally lodge in the tonsil
  • Larger FB more likely to impact in oesophagus and cause erosion / perforation or lower GI obstruction
  • Dentures are not all radio-opaque


Depends on location / type of FB and symptoms

Priority AIRWAY, B and C

  • If a FB in the throat, directly visualise. Check tonsils and valleculae
  • If in oesophagus, need AP & lat. x-rays to determine level
  • Proximal FB is more of an airway threat
  • Some dentures are not radio-opaque
  • Oesophageal FBs need to be removed endoscopically (urgently if button batteries or sharp)
  • Once past duodenum: obstruction = removal, asymptomatic = wait and see

Fish bones

Fish bones and x-rays


Barely visible

Not visible

Cod Monkfish Herring
Haddock Plaice Kipper
Cole fish Grey mullet Salmon
Lemon sole Red snapper Mackerel
Gurnard Trout

Button batteries

  • Dangerous if left in the oesophagus (corrosive, burn & release toxic metals)
  • They are benign once past the stomach

Paediatric Cases

Please see paediatric FB ingestion

Content by Dr Íomhar O' Sullivan. Last review Dr Simon Walsh, Dr ÍOS 26/03/24.