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Esophageal bougienage technique for coin ingestion in children
W A Bonadio1, J Z Jona, M Glicklich
1Department of Pediatrics, Medical College of Wisconsin, Children's Hospital, Milwaukee 53233.
Insights
Esophageal bougienage successfully removed ingested coins in 46 children. This safe and effective procedure advanced coins into the stomach without complications when specific patient criteria were met.
Area of Science:
- Pediatric Gastroenterology
- Endoscopy
- Foreign Body Ingestion
Background:
- Ingested coins are a common cause of esophageal foreign bodies in children.
- Traditional management may involve observation or more invasive procedures.
- Esophageal bougienage offers a less invasive alternative.
Purpose of the Study:
- To evaluate the safety and efficacy of esophageal bougienage for dislodging esophageal coin foreign bodies in pediatric patients.
- To determine the success rate and complication profile of this intervention.
Main Methods:
- A retrospective analysis of 46 children who underwent esophageal bougienage for a single, radiographically confirmed esophageal coin.
- Patients met strict inclusion criteria including acute ingestion, no prior esophageal issues, and no respiratory compromise.
- A single pass of a bougie dilator was used to advance the coin.
Main Results:
- Esophageal bougienage was successful in all 46 patients, with coins advanced to the stomach in one attempt.
- No procedural or post-procedural complications were observed.
- The procedure demonstrated high efficacy and safety in the selected pediatric population.
Conclusions:
- Esophageal bougienage is a safe and highly effective first-line treatment for esophageal coin foreign bodies in children meeting specific criteria.
- Rigid adherence to procedural criteria ensures successful outcomes and minimizes risks.
- This technique provides a valuable, minimally invasive option for pediatric foreign body management.
Abstract:
An analysis was performed of 46 consecutive children who received esophageal bougienage for an ingested coin lodged in the esophagus. All patients met the following clinical criteria necessary for performance of this procedure: an acutely ingested single coin, radiographically localized in the esophagus; no previous history of an esophageal disease process, surgical procedure performed or foreign body removed; and no respiratory compromise upon physical examination. All coins were successfully advanced distally into the stomach after one pass of the bougie dilator. No complications were noted during or after performance of any procedure. Esophageal bougienage is a safe and effective method used to dislodge and pass an ingested coin from the esophagus when criteria for its performance are adhered to rigidly.