FLUOROSCOPIC FOLEY CATHETER REMOVAL OF ESOPHAGEAL FOREIGN-BODIES IN CHILDREN - EXPERIENCE WITH 415 EPISODES

Objective. This study sought to investigate the safety and efficacy of the fluoroscopic Foley catheter technique (FFCT) for removal of esoph ageal foreign bodies (EFBs) in children, and to identify factors assoc iated with decreased success. Design/Setting/Patients. An 11-year retr ospective review of all pediatric patients undergoing the FFCT for rem oval of EFBs at a tertiary-care children's hospital was performed. Res ults. Four-hundred and fifteen cases are reported. The median age was 29 months (range, 4 to 193); children less than or equal to 24 months accounted for 45% (185) of the cases. Of all episodes 86% (355) involv ed children without known esophageal pathology. Coins comprised 76% (3 16) of the EFBs. The FFCT was successful in 91% (378) of the cases. In the 60 episodes involving children with underlying esophageal patholo gy, the technique had an 83% success rate compared to 92% in children without known pathology (P < .05). There were 290 patients where the d uration of impaction was known. The success rate was 96% if the durati on was 3 days or less compared to 50% if the duration was longer (P < .0001). Though the overall success in children less than or equal to 2 4 months was less than older children (88% vs 94%, P < .05), this effe ct disappeared when corrected for duration of impaction. Minor complic ations occurred in 2% of the episodes, and major complications were no ted in 1%. Conclusions. The FFCT appears to be a safe and effective me thod for removal of EFBs especially in children without underlying eso phageal lesions and a duration of impaction less than or equal to 3 da ys. Major complications are rare.