Foley catheter extraction of blunt esophageal foreign bodies

The case is reported of a successful Foley catheter extraction of two superimposed coins from the esophagus of an 8-year-old girl. The presence of the second coin was suspected only on review of the lateral cervical radiograph. In a previous report, failure to initially diagnose the presence of an additional coin resulted in an endoscopic failure to clear the esophagus. The technical aspects of Foley extraction are reviewed along with the controversy surrounding the procedure. Series totaling 294 cases document a cumulative success rate of 85% without significant complications. The technique, when performed by airway experts, is concluded to be a viable alternative to endoscopic removal. Lateral films, fluoroscopic extraction, and barium studies in select cases are recommended as safeguards against missing nonobvious foreign bodies of the esophagus.