Esophageal foreign bodies in children. 15-year review of 484 cases
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W S Crysdale1, K S Sendi, J Yoo
1Department of Otolaryngology, Hospital for Sick Children, Toronto, Canada.
Insights
This study analyzed 426 children with esophageal foreign bodies, finding coins were most common. Most cases required general anesthesia for removal, with few surgical interventions and no deaths.
Area of Science:
- Pediatric Gastroenterology
- Otolaryngology
- Pediatric Surgery
Background:
- Esophageal foreign bodies are a common pediatric emergency.
- Prompt diagnosis and management are crucial to prevent complications.
Purpose of the Study:
- To review the management and outcomes of pediatric esophageal foreign bodies.
- To identify common foreign body types, impaction sites, and associated anomalies.
Main Methods:
- Retrospective analysis of 426 children's charts.
- Data collected over 15 years (ending 1989) at a tertiary pediatric hospital.
- Review of management strategies, including anesthesia and surgical intervention.
Main Results:
- Coins were the most frequent foreign body, with the postcricoid area being the most common impaction site.
- General anesthesia with endotracheal intubation was used in 90% of removals.
- Esophageal anomalies were present in 59 children; less than 1% required thoracotomy or laparotomy.
- Complications occurred in 13% of patients, with no reported deaths.
Conclusions:
- Esophageal foreign body retrieval in children can be managed effectively with a high success rate.
- While complications can occur, mortality is rare.
- Awareness of associated esophageal anomalies is important in managing these cases.
Abstract:
The findings of a retrospective analysis of the charts of 426 children admitted on 484 occasions with diagnoses of esophageal foreign bodies that were managed at the Hospital for Sick Children for 15 years to the end of 1989 are reported. In the majority of cases, ingestion of the foreign body was either witnessed or suspected. Removal was completed with the use of general anesthesia with endotracheal intubation in 90% of cases. The postcricoid area was the commonest site for impaction. Coins were the commonest foreign body. Approximately 5% of children had more than one foreign body. Fifty-nine children had esophageal anomalies. Thoracotomy or laparotomy for the retrieval of foreign bodies was necessary in less than 1% of patients. Complications occurred in 13% of patients; there were no deaths.