title: Esophageal foreign bodies in the pediatric population: our first 500 cases.
abstract: BACKGROUND
  Children with esophageal foreign bodies are frequently seen by pediatric surgeons. Choking and dysphagia are common presentations; however, esophageal perforation has been reported. Historically, rigid esophagoscopy with extraction of the foreign body has been the recommended treatment. Alternatively, Foley balloon extraction is a safe and effective approach.
  
  
  METHODS
  Over a 16-year period, 555 children presented with an esophageal foreign body. Retrospective analysis of the medical record was undertaken. Statistics were by univariate analysis.
  
  
  RESULTS
  Two hundred ninety-eight boys and 257 girls presented with a mean age of 3.24 years. Dysphagia (37%) and drooling (31%) were the most common symptoms. Foreign bodies were lodged in the superior esophagus in 73%, and 88% of the objects were coins. Balloon extraction with fluoroscopy was performed in 468 children. Eighty percent of the objects were successfully removed with a mean fluoroscopy time of 2.2 min, and 8% were advanced into the stomach. The overall success rate was 88%, with failures necessitating rigid esophagoscopy under general anesthesia. Children younger than 1 year were the most likely to fail (25% failure rate). Airway aspiration never occurred. Significant savings in patient charges were observed with this approach.
  
  
  CONCLUSIONS
  Balloon extraction of pediatric esophageal foreign bodies is a safe and cost-effective procedure. This technique is applicable for infants, children, and adolescents. Experienced practitioners should be able to achieve greater than 80% success rate.
authors: Department of Surgery, Children's Mercy Hospital, Kansas City, MO 64108, USA.
authors: Danny C
authors: DC
authors: Little
authors: Sohail R
authors: SR
authors: Shah
authors: Shawn D
authors: SD
authors: St Peter
authors: Casey M
authors: CM
authors: Calkins
authors: Stephen E
authors: SE
authors: Morrow
authors: J Patrick
authors: JP
authors: Murphy
authors: Ron J
authors: RJ
authors: Sharp
authors: Walter S
authors: WS
authors: Andrews
authors: George W
authors: GW
authors: Holcomb
authors: Daniel J
authors: DJ
authors: Ostlie
authors: Charles L
authors: CL
authors: Snyder