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Esophageal food bolus impaction in pediatric age

Paolo Quitadamo1, Antonia Pascarella2, Piergiorgio Gragnaniello3

  • 1Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.

Journal of Pediatric Gastroenterology and Nutrition
|April 16, 2024
PubMed

Insights

Pediatric esophageal food impaction (EFI) is often linked to eosinophilic esophagitis (EoE), especially in older children. Prompt diagnosis and biopsies after endoscopic removal are crucial for complete evaluation.

Area of Science:

  • Pediatric Gastroenterology
  • Esophageal Disorders
  • Allergy and Immunology

Background:

  • Esophageal food impaction (EFI) is a sudden onset of dysphagia requiring endoscopic removal.
  • Limited data exists on the prevalence and causes of EFI in children.

Purpose of the Study:

  • To investigate the prevalence and underlying causes of esophageal food impaction in pediatric patients.
  • To provide insights into the diagnostic evaluation of pediatric EFI.

Main Methods:

  • Prospective enrollment of children with a first episode of EFI (March 2018-March 2023).
  • Fluoroscopic contrast study to confirm bolus presence and position.
  • Endoscopic bolus extraction (esophagogastroduodenoscopy) with routine esophageal biopsies for histology.

Main Results:

  • 41 children admitted for first-time EFI; drooling was the most common symptom.
  • Eosinophilic esophagitis (EoE) diagnosed in 48.8% of cases (20/41).
  • Other causes included strictures (anastomotic, peptic, congenital), caustic esophagitis, duplication, and achalasia; 25% had unidentified causes likely related to eating habits.

Conclusions:

  • This study is the largest series of pediatric patients evaluated for food bolus impaction.
  • EoE is a frequent underlying condition, accounting for half of EFI episodes in children, particularly older ones.
  • Esophageal biopsies post-endoscopic removal are vital for comprehensive diagnosis in pediatric EFI.
Abstract

Keywords:
droolingdysphagiaendoscopic removal

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