title: Management of esophageal foreign bodies: experience in a developing country.
abstract: BACKGROUND
  The outcome of esophagoscopy for removal of suspected esophageal foreign bodies (EFBs) is dependent on the FB characteristics and the surgeon's experience. This study was conducted to review our experience and highlight challenges in the management of EFBs in a developing country. The value of radiologic signs in FB detection was also evaluated.
  
  
  METHODS
  We conducted a retrospective chart review of 131 patients: 58.8% males and 41.9% females aged 8 months to 64 years, treated for suspected EFBs in our institution over a 13-year period. Statistics were derived by univariate analysis
  
  
  RESULTS
  Foreign bodies were found and retrieved in 118 cases. Coins were the predominant FB in children (35%), and bones (25%) and dentures (17%) were predominant in adults. Plain radiography was highly useful in detecting FBs in children (coins/metals 100%) but less so in adults (bones 25%, dentures 11%). Repeated esophagoscopy attempts were encountered more in patients with impacted sharp objects (85%) and were recorded significantly among trainee surgeons (p = 0.004). Open esophagotomy was carried out in 13 (10%) difficult cases. Major complications including two iatrogenic esophageal perforations and one death occurred following esophagoscopy by trainee surgeons.
  
  
  CONCLUSIONS
  Rigid esophagoscopy is relatively safe and useful procedure in trained hands for removal of EFBs. Management of long-standing EFBs, dentures, and other sharp objects requires the skills of the most experienced members of the surgical team for a successful outcome. Open surgical treatment is unavoidable in cases of irretrievable esophageal FBs or in the presence of esophageal perforation.
authors.affiliation: Department of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, Nigeria. tochiorji@yahoo.com.|Abia State University Teaching Hospital, Aba, Abia State, Nigeria. tochiorji@yahoo.com.|Sunshine Hospital, Umuahia, Abia State, Nigeria. tochiorji@yahoo.com.
authors.forename: Foster Tochukwu
authors.initials: FT
authors.lastname: Orji
authors.affiliation: Department of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: James O
authors.initials: JO
authors.lastname: Akpeh
authors.affiliation: Department of Surgery, Delta State University, Abraka, Nigeria.
authors.forename: Nekwu E
authors.initials: NE
authors.lastname: Okolugbo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004939:Esophageal Perforation / Q000209:etiology; D004945:Esophagoscopy / Q000009:adverse effects / Q000401:mortality; D004947:Esophagus / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult