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Clinical effectiveness of bougienage for esophageal coins in a pediatric ED

Evan H Allie1, Aaron M Blackshaw2, Joseph D Losek3

  • 1Medical University of South Carolina Children's Hospital, Department of Pediatrics Residency Program, Charleston, SC.

The American Journal of Emergency Medicine
|September 3, 2014
PubMed

Insights

Bougienage is a safe and effective treatment for esophageal coins in children, offering significant time and cost savings compared to surgical retrieval. This pediatric emergency department experience highlights its benefits.

Area of Science:

  • Pediatric Emergency Medicine
  • Gastroenterology
  • Medical Device Technology

Background:

  • Esophageal coins are a common pediatric foreign body ingestion.
  • Traditional management may involve invasive procedures.
  • Bougienage offers a less invasive alternative.

Purpose of the Study:

  • To evaluate the safety and efficacy of esophageal bougienage for coin removal in children.
  • To compare bougienage outcomes with surgical retrieval.
  • To assess the cost-effectiveness and efficiency of bougienage.

Main Methods:

  • Retrospective case series of 245 children with esophageal coins.
  • Inclusion criteria: medically stable, no prior GI surgery, single coin, witnessed ingestion < 24 hours.
  • Data abstracted: demographics, management, success rates, complications, length of stay, hospital charges.

Main Results:

  • Bougienage achieved 94% procedural success; surgical retrieval was 100% successful.
  • Bougienage resulted in fewer complications (18 minor) vs. surgery (10 minor, 2 major).
  • Bougienage significantly reduced length of stay (137 min vs. 769 min) and hospital charges ($984 vs. $7022).

Conclusions:

  • Esophageal bougienage is a safe and highly effective first-line treatment for pediatric esophageal coins.
  • Bougienage is more time-efficient and cost-effective than surgical retrieval.
  • This technique offers significant advantages in pediatric emergency care settings.
Abstract

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