CAPS Original paperEsophageal foreign bodies in the pediatric population: our first 500 cases
Section snippets
Methods
Over the 16-year period from January 1988 to October 2004, 555 children presented to the emergency department at Children's Mercy Hospital, Kansas City, Mo, with a foreign body lodged in the esophagus. After institutional review board approval, the medical records were queried for patient demographics and presenting symptoms. Imaging studies were reviewed. When available, fluoroscopy time was noted. Patient charges for balloon extraction and operative rigid esophagoscopy were compared.
Results
A total of 555 children (298 boys and 257 girls), aged 2 months to 19 years, were included in the study. The mean age was 3.24 years (2 months to 19 years). Dysphagia, drooling, and choking were the most common presenting symptoms (Fig. 1). Chest roentgenograms were obtained in 93% of the children. Additional imaging included dedicated neck radiographs (29%), abdominal films (27%), and esophagrams (6%). Foreign bodies were most commonly identified in the superior esophagus (Fig. 2). Although
Discussion
In 1966, Bigler [14] reported a method of extracting smooth esophageal foreign bodies using a Foley balloon catheter. In his original article, Bigler reported the successful removal of a coin and a jack from 2 children. He hypothesized that distension of the Foley balloon inferior to the foreign body would dilate the esophagus, free the impaction, and allow safe extraction of the foreign body. Over the following 40 years, esophageal foreign bodies have become a relatively common problem shared
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Pediatrics
Esophageal foreign bodies
Am Fam Physician
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Presented at the 37th Annual Meeting of the Canadian Association of Paediatric Surgeons, Quebec, Canada, September 22-25, 2005.