Esophageal foreign body obstruction after esophageal atresia repair.
OBJECTIVE
The aim of this study was to determine the incidence and risk factors for esophageal foreign body obstruction (EFBO) after esophageal atresia/tracheoesophageal fistula (EA-TEF) repair.


METHODS
A Case-control chart review was conducted from 1987 to 1999.


RESULTS
EFBO occurred in 14 of 108 patients (13%) with EA-TEF. Mean follow-up was 31 months. Alimentary debris was the most common foreign body. Mean time between operation and EFBO was 25 months. EFBO recurred in 50%. Sixty-one percent of patients required endoscopic FB removal. Esophageal stenosis was present in 57% of EFBO patients, and 80% of stenoses presented initially with EFBO. The incidence of gastroesophageal reflux (GER; 50%), type C anomaly (100%), anastomotic leak (21%), major associated anomalies (50%), and encephalopathy (14%) were not significantly different between the EFBO group and the total EA-TEF population. There was no difference in the need for antireflux surgery (57%) between those with EFBO and GER and the total EA/TEF population with GER.


CONCLUSIONS
Esophageal foreign body obstruction occurs in at least 13% of patients after EA-TEF repair. Because no reliable risk factors were identified that could predict foreign body obstruction, all families should be warned about this possibility during the first 5 years, particularly once the child begins eating solid foods.
Zigman
Andrew
A
Montreal, Quebec.
Yazbeck
Salam
S
D016022:Case-Control Studies; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology; D004947:Esophagus; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000175:diagnosis / Q000453:epidemiology*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D011183:Postoperative Complications / Q000453:epidemiology*