Analysis of 334 Cases of Pediatric Esophageal Foreign Body Removal Suggests that Traditional Methods Have Similar Outcomes Whereas a Magnetic Tip Orogastric Tube Appears to be an Effective, Efficient, and Safe Technique for Disc Battery Removal

Ham, P. Benson; Ellis, Mark A.; Simmerman, Erika; Walsh, Nathaniel J.; Lalani, Alykhan; Young, Morgan; Hatley, Robyn M.; Howell, Charles G.; Hughes, C.

doi:10.1177/000313481808400729

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Concerns that have been raised include the inability to inspect the esophageal mucosa after removal, the possibility of missing other ingested objects that are not radio-opaque, lack of airway protection during the procedure, radiation exposure, and discomfort of the patient. 15 16 17 However, this study and other articles have shown that both fluoroscopy time, with a mean time between 2 and 2.5 minutes, and complication rates, with 10 or fewer complications reported in each study, are low. 5 8 No patients in our population returned to the ER due to persistent symptoms related to an undiagnosed, retained second radiolucent foreign body.…”

Section: Discussioncontrasting

confidence: 57%

30 Years of Flipping the Coin—Heads or Tails?

et al. 2020

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Introduction Swallowed coins are a frequent cause of pediatric emergency department visits. Removal typically involves endoscopic retrieval under anesthesia. We describe our 30-year experience retrieving coins using a Foley catheter under fluoroscopy (“coin flip”). Materials and Methods Patients younger than 18 years who underwent the coin flip procedure from 1988 to 2018 were identified. Failure of fluoroscopic retrieval was followed by rigid endoscopic retrieval in the operating room. Detailed subanalysis of patients between 2011 and 2018 was also performed. Results A total of 809 patients underwent the coin flip procedure between 1988 and 2018. Median age was 3.3 years; 51% were male. The mean duration from ingestion to presentation was 19.8 hours. Overall success of removal from the esophagus was 85.5%, with 76.5% of coins retrieved and 9% pushed into the stomach. All remaining coins were retrieved by endoscopy. Complication rate was 1.2% with nine minor and one major complications, a tracheal tear that required repair. In our recent cohort, successful fluoroscopic removal led to shorter hospital lengths of stay (3.2 vs. 18.1 hours, p < 0.001). Conclusion Patients who present with a coin in the esophagus can be successfully managed with a coin flip, which can be performed without hospital admission, with rare complications.

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Section: Discussioncontrasting

confidence: 57%

30 Years of Flipping the Coin—Heads or Tails?

et al. 2020

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“…For the retrieval methods, the oral-gastric tube with a magnetic tip under fluoroscopy and rigid esophageal endoscopy technique have the highest success rates [ 7 ], but each method has its own risks to consider. Rigid esophageal endoscopy may slightly increase the perforation rate [ 8 ], although the difference has not been shown to be significant in children [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

A novel approach to button battery removal in a two-and-half year-old patient’s esophagus after ingestion: a case report

Wang

Lin

et al. 2022

BMC Pediatr

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Background Accidental swallowing of a foreign body occurs more frequently in children than in adults. Among these cases, button battery impaction in the esophagus may cause severe complications. While prevention is always ideal, if button battery impaction is suspected, immediate diagnosis and retrieval are important. Case presentation We introduce a novel method for retrieval of a button battery after ingestion by a 2.5-year-old child. When the patient arrived at our center, the battery was incarcerated in the upper esophagus. The battery could not be removed, despite the use of several methods such as alligator forceps under endoscopy and net retrieval. We decided to use a novel method that combined endoscopic balloon extraction and forceps retrieval. This resulted in a push-and-pull effect, creating synergy and easy removal of the battery. There were no long term complications based on the follow-up endoscopy examination. Conclusions This new procedure was very effective for removing the esophageal foreign body. When button battery in esophagus was too tight to be removed by the traditional retrieval methods, this procedure was suggested to use. It could be performed at medical institutions. If it fails or esophageal perforation (iatrogenic or spontaneous) occurs, pediatric surgeons could take over immediately.

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“…A magnet-tipped orogastric tube was observed to be the most rapid method for disk battery removal, associated with a high success rate compared with balloon extraction, flexible endoscopy, and rigid esophagoscopy [ 38 ].…”

Section: Advantage Over Endoscopic Removalmentioning

confidence: 99%

Foreign Body Removal in Children Using Foley Catheter or Magnet Tube from Gastrointestinal Tract

Choe

2019

Pediatr Gastroenterol Hepatol Nutr

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Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).

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Analysis of 334 Cases of Pediatric Esophageal Foreign Body Removal Suggests that Traditional Methods Have Similar Outcomes Whereas a Magnetic Tip Orogastric Tube Appears to be an Effective, Efficient, and Safe Technique for Disc Battery Removal

Cited by 6 publications

References 15 publications

30 Years of Flipping the Coin—Heads or Tails?

30 Years of Flipping the Coin—Heads or Tails?

A novel approach to button battery removal in a two-and-half year-old patient’s esophagus after ingestion: a case report

Foreign Body Removal in Children Using Foley Catheter or Magnet Tube from Gastrointestinal Tract

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