Chronic esophageal foreign bodies in pediatric patients: a retrospective review.
OBJECTIVE
Chronic esophageal foreign bodies (CEFB) are associated with a high incidence of morbidity and mortality in adults. However, the presentation, management and outcome of chronic esophageal foreign bodies in children are not well described.


METHODS
We performed a retrospective chart review of children with chronic esophageal foreign bodies admitted to the Children's Hospital Medical Center, Cincinnati, OH, between May 1990 and January 2002. A chronic esophageal foreign body was defined as a foreign body estimated to have been present for over 1 week.


RESULTS
Over the inclusion period, 522 children were admitted with esophageal foreign bodies, 41 (8%) of which were chronic. The most common foreign bodies were coins. Seventy-six percent of patients presented with a primary complaint of respiratory symptoms, with respiratory distress being the most common followed by asthmatic symptoms and cough. Twenty-two percent of patients had primarily gastrointestinal symptoms including nausea/vomiting and dysphagia. One patient was asymptomatic on presentation. A perforated esophagus was identified in 18 patients, with 17 of these being a technically perforated esophagus and one case being a classic esophageal perforation. There were no deaths or permanent morbidity in this series.


CONCLUSIONS
Respiratory symptoms are more common than gastrointestinal symptoms in pediatric patients with chronic esophageal foreign bodies. Removal by rigid esophagoscopy is recommended. A small proportion of cases require open removal of the foreign body. Conservative management is appropriate for the technically perforated esophagus. A good outcome should be anticipated for the majority of cases.
Miller
Robert Sean
RS
Department of Otolaryngology/Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, PO Box 670528, 45267-0528 Cincinnati, OH, USA. linusnavypilot@hotmail.com
Willging
J Paul
JP
Rutter
Michael J
MJ
Rookkapan
Korpong
K
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004947:Esophagus; D005260:Female; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D012120:Respiration Disorders / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome