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Endoscopic examination has a role in the assessment of these cases with two caveats. It is frequently impossible to fully evaluate the esophageal wall overlying the foreign body before the foreign body is retrieved and bleeding may impede visualization post retrieval (Figure 4.6). The clinician must be aware that insufflation of air via the endoscope may exacerbate a pneumomediastinum or pneumothorax in animals with esophageal perforation. Hence, careful anesthetic monitoring is critical in detecting any deterioration in oxygenation. In such an event, prompt thoracocentesis is indicated; ideally following survey radiography if the animal's conditions allow for this delay. Suction is invaluable in clearing frothy saliva to achieve an unobscured endoscopic view. The esophageal wall is often inflamed or ulcerated but unless significant trauma to the muscular layers of the esophagus has occurred, stricture is unlikely to follow (Figure 4.7).