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
Little, Danny C.; Shah, Sohail R.; St Peter, Shawn D.; Calkins, Casey M.; Morrow, Stephen E.; Murphy, J Patrick; Sharp, Ron J.; Andrews, Walter S.; Holcomb, G W. III; Ostlie, Daniel J.; and Snyder, Charles L., "Esophageal foreign bodies in the pediatric population: our first 500 cases." (2006). Manuscripts, Articles, Book Chapters and Other Papers. 580.