Impacted esophageal foreign bodies in children
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Read the article on link.springer.com ↗Article · Jan 2023 · 1 min read
In brief
In brief
This retrospective study of 86 children with impacted esophageal foreign bodies identifies two distinct clinical patterns: those with underlying anatomical abnormalities present earlier with recurrent food impactions requiring multiple interventions, while those with normal anatomy typically have benign coin ingestions. Recognition of predisposing esophageal pathology is critical for appropriate management and follow-up planning.
Written by the GCMD Library team from the article.
Abstract
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.