Impacted esophageal foreign bodies in children

Purpose Foreign body (FB) ingestion in children has varied presentation. When unwitnessed, it poses therapeutic and diagnostic challenges especially in the presence of pre-existing anatomical pathology. We aim to analyze the clinical course, management, and outcome of children with impacted esophage...

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Bibliographic Details
Published in:Pediatric surgery international 2023-01, Vol.39 (1), p.73-73, Article 73
Main Authors: Raju, Rajkiran S., Raj, A. John Michael, Shubha, A. M.
Format: Article
Language:English
Subjects:
Age
Asymptomatic
Catheters
Child
Endoscopy
Esophagus
Esophagus - diagnostic imaging
Esophagus - surgery
Failure to thrive
Females
Fistula
Foreign bodies
Foreign Bodies - diagnostic imaging
Foreign Bodies - surgery
Hospitals
Humans
Medicine
Medicine & Public Health
Pathology
Patients
Pediatric Surgery
Pediatrics
Retrospective Studies
Review Article
Stomach
Surgery
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Summary:Purpose Foreign body (FB) ingestion in children has varied presentation. When unwitnessed, it poses therapeutic and diagnostic challenges especially in the presence of pre-existing anatomical pathology. We aim to analyze the clinical course, management, and outcome of children with impacted esophageal FBs. Methods Retrospective chart review (Jan 2000–Feb 2018) recruiting children with impacted esophageal FBs. FBs in cricopharynx and those that moved to stomach were excluded. Investigations/management were based on underlying anatomical pathology, duration of impaction, and difficult FBs. Clinical details, management, and outcomes were collated. Results Of 86 children, N1 = 31 had identifiable predisposing anatomic pathology and N2 = 55 had impactions in normal esophagus or difficult FBs. N1 group presented early (42 months), had recurrent impactions (1–6), and needed multiple dilatations (0–8) and longer follow-up (avg 35 months). Food matter was commonest impaction. Many had persistent symptoms. N2 group had commonly coin impactions and strictures developed in long standing or corrosive FBs. Most were asymptomatic. Conclusion Abnormal esophageal anatomy predisposes to impaction with organic food bolus. Age of presentation is earlier with recurrent impactions requiring multiple dilatations/surgery and longer follow-up. Metallic FBs commonly impact in normal esophagus and are often innocuous. Atypical/multiple FBs may mirror an underlying psychiatric illness.
ISSN:1437-9813
0179-0358
1437-9813
DOI:10.1007/s00383-022-05360-3