PEDIATRICS Vol. 94 No. 5 November 1994, pp. 709-714
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Fluoroscopic Foley Catheter Removal of Esophageal Foreign Bodies in Children: Experience With 415 Episodes

Jeff E. Schunk MD1, A. Marc Harrison MD1, Howard M. Corneli MD1, and G. William Nixon MD2

1 Department of Pediatrics, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT
2 Department of Radiology, University of Utah School of Medicine, Primary Children's Medical Center, Salt Lake City, UT

Objective. This study sought to investigate the safety and efficacy of the fluoroscopic Foley catheter technique (FFCT) for removal of esophageal foreign bodies (EFBs) in children, and to identify factors associated with decreased success.

Design/Setting/Patients. An 11-year retrospective review of all pediatric patients undergoing the FFCT for removal of EFBs at a tertiary-care children's hospital was performed.

Results. Four-hundred and fifteen cases are reported. The median age was 29 months (range, 4 to 193); children le 24 months accounted for 45% (185) of the cases. Of all episodes 86% (355) involved children without known esophageal pathology. Coins comprised 76% (316) of the EFBs.

The FFCT was successful in 91% (378) of the cases. In the 60 episodes involving children with underlying esophageal pathology, the technique had an 83% success rate compared to 92% in children without known pathology (P < .05). There were 290 patients where the duration of impaction was known. The success rate was 96% if the duration was 3 days or less compared to 50% if the duration was longer (P < .0001). Though the overall success in children le 24 months was less than older children (88% vs 94%, P < .05), this effect disappeared when corrected for duration of impaction.

Minor complications occurred in 2% of the episodes, and major complications were noted in 1%.

Conclusions. The FFCT appears to be a safe and effective method for removal of EFBs especially in children without underlying esophageal lesions and a duration of impaction le 3 days. Major complications are rare.

Submitted on October 19, 1993
Accepted on March 15, 1994




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