ESOPHAGEAL FOREIGN-BODIES IN CHILDREN - DIAGNOSIS, TREATMENT, AND COMPLICATIONS

OBJECTIVE. We performed this study to identify the role of radiology i n the diagnosis, treatment, and complications of esophageal foreign bo dies in children. MATERIALS AND METHODS. We retrospectively reviewed t he charts and radiographs of 123 esophageal foreign bodies seen in 118 children at the Medical University of South Carolina from May 1980 th rough May 1995. RESULTS. Most foreign bodies were coins in the upper e sophagus (69%) in infants less than 2 years old (65%) for fewer than 2 4 hr (60%). The presenting symptoms varied, with 20% of patients asymp tomatic. Respiratory symptoms that mimicked upper respiratory tract in fections or croup proved misleading with long-standing foreign body re tention. Preexisting esophageal disease was present in 17% of patients . The Foley catheter method of foreign body extraction was attempted i n 53 cases (43%) and was successful without complications in 46 (87%). Esophagoscopy was attempted in 72 cases (58%) and was successful with out complications in 66 (92%). Three patients had major complications: a fatal aorticoesophageal fistula, an extraluminal migration of a coi n, and a large esophageal diverticulum, Significant mucosal erosions w ere shown in six patients on radiologic studies after extraction. CONC LUSION. Early recognition and treatment of esophageal foreign bodies i s imperative because the complications are serious and can be life-thr eatening. Radiology plays an important role in the initial diagnosis, in recognition of complications, and in treatment. The Foley catheter method of foreign body extraction can be used on some patients, but es ophagoscopy remains the safest method of esophageal foreign body extra ction.