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

Abstract

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).

Pediatric Endoscopy, Update 2020

“…For instance, some objects with a small hole can be removed by insertion of a forceps through the hole and open the forceps behind. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies [77]. The success rates for rigid esophagoscopy (100%) and flexible endoscopy (96.2%) were not significantly different (p > 0.05).…”

Increase of foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

“…Most objects will pass the gastrointestinal tract (GIT) spontaneously, especially if they have reached the small intestine at initial location and even up to 50% of large foreign bodies (FB) with a diameter over 30 mm may pass the GIT without intervention [10,11]. However, FBs in the oesophagus or sharp and relatively large FBs will require an intervention, mostly rigid or exible endoscopy and rarely by Foley catheter extraction, oesophageal bougienage, McGill forceps and magnetic catheter [1,2,12,13]. Button batteries, multiple magnets and sharp objects need to be removed immediately to avoid serious complications [2,4,[14][15][16][17][18][19].…”

Increase in foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

“…In contrast, FBs lodged in the oesophagus or sharp and relatively large FBs will require an intervention. In such cases, rigid or exible endoscopy are typically used, where Foley catheter extraction, oesophageal bougienage, McGill forceps and magnetic catheters are less frequently implemented [5,6,15,16]. Button batteries, multiple magnets and sharp objects need to be removed immediately to avoid serious complications [5,7,[17][18][19][20][21][22].…”