[Food bolus obstruction of the oesophagus or ingestion of a foreign body; what should you do?].

A food bolus obstruction of the oesophagus and foreign body ingestion are frequently encountered in common clinical practice. There is currently no guideline in the Netherlands for management of these problems. We present two cases to illustrate how these can be managed in line with European and American guidelines. The first patient was a 36-year-old female with total obstruction of the oesophagus by a food bolus. Biopsies taken following endoscopic removal showed eosinophilic infiltration of the mucosa and a subsequent diagnosis of eosinophilic oesophagitis. Symptoms resolved following medical treatment. The second patient, a 23-year-old male with psychomotoric retardation, presented following ingestion of a steel fork. The patient had a previous history of three laparotomies because of ingestion of a foreign body. Endoscopic removal was not possible, and a fourth laparotomy was performed to remove the fork. Food bolus obstruction is a gastroenterological emergency that warrants swift endoscopic removal. In cases of ingestion of a foreign body, the characteristics of the object must be taken into account when determining timing of endoscopic removal.