Esophageal foreign bodies in the pediatric population: our first 500 cases.
BACKGROUND: Children with esophageal foreign bodies are frequently seen by pediatric surgeons. Choking and dysphagia are common presentations; however, esophageal perforation has been reported. Historically, rigid esophagoscopy with extraction of the foreign body has been the recommended treatment. Alternatively, Foley balloon extraction is a safe and effective approach.
METHODS: Over a 16-year period, 555 children presented with an esophageal foreign body. Retrospective analysis of the medical record was undertaken. Statistics were by univariate analysis.
RESULTS: Two hundred ninety-eight boys and 257 girls presented with a mean age of 3.24 years. Dysphagia (37%) and drooling (31%) were the most common symptoms. Foreign bodies were lodged in the superior esophagus in 73%, and 88% of the objects were coins. Balloon extraction with fluoroscopy was performed in 468 children. Eighty percent of the objects were successfully removed with a mean fluoroscopy time of 2.2 min, and 8% were advanced into the stomach. The overall success rate was 88%, with failures necessitating rigid esophagoscopy under general anesthesia. Children younger than 1 year were the most likely to fail (25% failure rate). Airway aspiration never occurred. Significant savings in patient charges were observed with this approach.
CONCLUSIONS: Balloon extraction of pediatric esophageal foreign bodies is a safe and cost-effective procedure. This technique is applicable for infants, children, and adolescents. Experienced practitioners should be able to achieve greater than 80% success rate.
Journal of pediatric surgery
Adolescent; Adult; Catheterization; Child; Child, Preschool; Esophagoscopy; Esophagus; Female; Fluoroscopy; Foreign Bodies; Humans; Infant; Male; Retrospective Studies
Extraction; Foreign bodies
Little, D. C., Shah, S. R., St Peter, S. D., Calkins, C. M., Morrow, S. E., Murphy, J. P., Sharp, R. J., Andrews, W. S., Holcomb, G. W., Ostlie, D. J., Snyder, C. L. Esophageal foreign bodies in the pediatric population: our first 500 cases. Journal of pediatric surgery 41, 914-918 (2006).