The Use of a Foley Catheter for Removal of Blunt Esophageal Foreign Bodies from Children

Shackelford, Gary D.; McAlister, William H.; Robertson, Charles L.

doi:10.1148/105.2.455

Cited by 27 publications

(5 citation statements)

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“…We performed this study to identify the role of radiology in the diagnosis, treatment, [4,5], and pediatric radiologists became involved in the treatment as well as the diagnosis of esophageal foreign bodies [6,7]. Although this technique offers a fast, effective, and inexpensive alternative to esophagoscopy, some controvemsy exists about its safety [8].…”

Section: Objectivementioning

confidence: 99%

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Macpherson¹,

Hill²,

Othersen³

et al. 1996

American Journal of Roentgenology

113

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Section: Objectivementioning

confidence: 99%

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Macpherson¹,

Hill²,

Othersen³

et al. 1996

American Journal of Roentgenology

113

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“…Previous authors report a success rate of up to 95% using the balloon extraction technique [2,3]. In our series we have succeeded in only 67% of cases.…”

Section: Discussionmentioning

confidence: 44%

“…Using this method several investigators have reported a success rate of up to 95% [2,3]. We wish to report a patient group in which catheter extraction of esophageal foreign bodies was less successful, and a radiographic sign which appears to be predictive of an unsuccessful foreign body removal.…”

mentioning

confidence: 99%

Esophageal edema as a predictor of unsuccessful balloon extraction of esophageal foreign body

Towbin

Lederman

et al. 1989

Pediatr Radiol

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In 1966 Bigler described a method for extraction of impacted foreign bodies with the use of a Foley catheter [1]. Using this method several investigators have reported a success rate of up to 95% [2,3]. We wish to report a patient group in which catheter extraction of esophageal foreign bodies was less successful, and a radiographic sign which appears to be predictive of an unsuccessful foreign body removal. Material and methodsOver a 5 year period, fifty-eight children presented to the Radiology Department of Children's Hospital Medical Center, Cincinnati with esophageal foreign bodies. 3-he radiographs and medical records were retrospectively reviewed for the sex, age at presentation, type and location of the foreign body, and for the success rate of removal using the Foley catheter extraction technique.Chest radiographs in anteroposterior position were available for review in all patients. Lateral radiographs were not routinely obtained but were available for review in all children with difficult or failed balloon extraction and in a majority of children whose foreign bodies were successfully removed.Our technique for esophageal foreign body removal is similar to that presented by other authors [2,[4][5][6], and therefore will only be briefly described. Smooth, radiopaque objects are considered for removal regardless of how 10ng they have been in place as long as no contraindication is present, Contra-indication to balloon extraction included signs of esophageal perforation, widened mediastinum on chest radiograph, or a bleeding diathesis. Prior to removal, a resuscitation cart is brought into the room, opened, and prepared for potential use. The nasal route is preferred and prior to catheter insertion, the nose may be anesthetized with local anesthetic. A 12 French Foley catheter with a 5 cc balloon is usually selected. Younger children are placed on an octagon board (Enterprises Octostop, Montreal, Canada), while older children are "mummy wrapped" in sheets when necessary. The balloon is tested and under fluoroscopic guidance positioned distal to the foreign body. With the child in the RPO position and the table in Trendelenburg, the balloon is inflated so that it fills the esophageal lumen. The inflated balloon is slowly withdrawn and the foreign body pulled into the mouth. If the coin is not immediately * Current address: Department of Radiology, Children's Hospital of Michigan, Detroit, Michigan, USA spit out, a bite block is positioned between the molar teeth and a finger is inserted to remove the foreign body. ResultsOver a five year period, fifty-eight children (36 males and 22 females) with esophageal foreign bodies were examined. The patients ranged in age from 7 to 166 months, had a mean age of 44 months, and 47% were less than 24 months of age. Coins were retained in the esophagus in 48%, miscellaneous foreign bodies including safety pins, chicken bones, cardboard, thumbtacks, a jack, key and coilspring were present in 28% and food in 24%. Foreign body removal was attempted only in patients with bl...

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“…10 Since then, multiple case series have been reported. 1,6,8,[11][12][13][14] However, this technique is still not widely used. 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.…”

Section: Discussionmentioning

confidence: 99%

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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The Use of a Foley Catheter for Removal of Blunt Esophageal Foreign Bodies from Children

Cited by 27 publications

References 0 publications

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Esophageal edema as a predictor of unsuccessful balloon extraction of esophageal foreign body

30 Years of Flipping the Coin—Heads or Tails?

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