Esophageal food impaction in children.
OBJECTIVE
To determine the clinical presentation, radiographic, endoscopic and manometric findings, and clinical outcome of esophageal food impaction (EFI) in pediatric patients.


METHODS
We retrospectively reviewed the clinical course of 12 pediatric patients with EFI over a 10-year period.


RESULTS
All 12 patients described initially presented to our emergency department for care. Four patients (25%) required previous endoscopic intervention for disimpaction of EFI. Eleven required endoscopic removal of their EFI, and 1 patient's food impaction resolved spontaneously. The mean duration of food impaction was 20 hours prior to endoscopic intervention. Endoscopy demonstrated an esophageal stricture in 1 patient with a history of trisomy 21 and tracheoesophageal fistula repair. While there was no visual evidence of esophagitis in any patient, 5 of 7 had histologic evidence of esophagitis. Upper gastrointestinal series demonstrated the esophagus to be anatomically normal in 10 of 12 patients (83%); 1 patient had an esophageal stricture and another an esophageal web. Four of 8 patients studied had nonspecific esophageal motility abnormalities.


CONCLUSIONS
EFI in children is not generally associated with underlying esophageal anatomic abnormalities. Esophagitis and nonspecific esophageal motility disorder abnormalities may be etiologic factors. Endoscopic removal of the EFI was safe and effective and is recommended as there is little likelihood of spontaneous resolution of EFI in children.
Lao
Jimmy
J
Division of Pediatric Gastroenterology and Nutrition, New York Medical College, Munger Pavilion, Room 101, Valhalla, NY 10595, USA.
Bostwick
Howard E
HE
Berezin
Stuart
S
Halata
Michael S
MS
Newman
Leonard J
LJ
Medow
Marvin S
MS
D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D004630:Emergencies; D015154:Esophageal Motility Disorders / Q000150:complications; D004940:Esophageal Stenosis / Q000150:complications; D004945:Esophagoscopy; D004947:Esophagus; D005260:Female; D005502:Food; D005547:Foreign Bodies; D006801:Humans; D008297:Male; D008365:Manometry; D011183:Postoperative Complications; D012189:Retrospective Studies; D013525:Surgical Instruments; D014138:Tracheoesophageal Fistula / Q000601:surgery