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Foreign body impaction in the esophagus is common in children, often caused by coins. Adults present with different foreign bodies and underlying conditions, leading to more complications.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Otolaryngology
Background:
- Esophageal foreign body impaction is a significant clinical issue, particularly in pediatric populations.
- Understanding the demographics, common etiologies, and anatomical locations is crucial for effective management.
Purpose of the Study:
- To analyze the characteristics of esophageal foreign body impaction in a cohort of patients.
- To compare foreign body types, predisposing factors, and impaction sites between children and adults.
Main Methods:
- Retrospective analysis of 54 patients with esophageal foreign body impaction.
- Data collection included patient age, foreign body type, predisposing factors, impaction location, and management outcomes.
- Oesophagoscopy under general anesthesia was the primary removal method.
Main Results:
- Coins were the most frequent foreign body in children (27/45), with most impacted in the upper esophagus.
- Meat bolus was most common in adults (9/9), often associated with underlying esophageal or systemic conditions (88% of adults).
- Complications were more prevalent in adults, largely attributed to pre-existing medical conditions.
Conclusions:
- Esophageal foreign body impaction differs significantly between pediatric and adult populations regarding etiology and location.
- While coins are common in children, adults often have meat impaction linked to underlying pathologies.
- Prompt oesophagoscopy is essential for removal, with careful consideration of adult comorbidities to minimize complications.
Abstract:
Impaction of foreign bodies in the oesophagus was analysed in 54 patients, 45 of whom were children. Of the 45 children 28 were aged 2-4 years. Coins were the most common foreign body in children (27 cases) while in adults a bolus of meat was most common (nine cases). In 41 children there was no predisposing factor, but an underlying mechanism was detected in 88% of the adults. The mechanisms were of three types: oesophageal (stricture), neuromuscular (myasthenia gravis), and extrinsic and mechanical (ankylosing spondylitis). In children most of the foreign bodies were impacted in the upper oesophagus at the cricopharyngeal junction, which is the narrowest part of the oesophagus, while in adults the foreign body was usually impacted at the site of the predisposing lesion or in the lower oesophagus. In all patients oesophagoscopy was performed under general anaesthesia to remove the impacted foreign body. Complications were more frequent in adults, mainly owing to the underlying condition.