title: Esophageal foreign bodies in children: Emphasis on complicated cases.
abstract: BACKGROUND
  Esophageal foreign bodies (EFBs) are a relatively common clinical problem in pediatric patients. The majority of EFBs pass harmlessly through the gastrointestinal tract; however, some EFBs can cause significant morbidities. This study was conducted to review our experience in managing esophageal foreign bodies in pediatric patients, with an emphasis on the management and outcomes of complicated cases.
  
  
  METHODS
  Between March 1995 and March 2013, the records of all children up to the age of 12 years who were admitted to King Khalid University Hospital, Riyadh, Saudi Arabia, with a final diagnosis of EFBs were reviewed. The medical records were analyzed with respect to demographic data, presenting symptoms, workup investigation, management, complications, and outcomes.
  
  
  RESULTS
  Seventy patients were identified (38 boys and 32 girls). The ages ranged from 5 days to 12 years (mean: 4.4 years). Fifty-three (75.7%) patients presented within 24 hours. Thirteen (18.6%) patients had underlying predisposing factors. The most common EFB, found in 30 (42.8%) patients, was a coin. Witnessed ingestion of a FB was documented in 52 (74.2%) patients. The most common symptoms were drooling of saliva in 42 (60%) patients, followed by vomiting in 36 (51.4%) patients. Four (5.7%) patients presented with complications secondary to FB impaction, including hypopharyngeal wall perforation, acquired esophageobronchial fistula, localized esophageal perforation with inflammation, and perforation with stricture formation. The follow-up period ranged from 2 to 12 months, and all patients had complete recovery without any sequelae.
  
  
  CONCLUSIONS
  EFBs are a relatively common problem in pediatric patients, and underlying predisposing factors to EFB impaction are not uncommon. Long-retained EFBs are associated with a higher incidence of complications. Rigid esophagoscopy was successful in extracting most of the EFBs and was shown to be a safe and effective procedure.
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: taltokhais@ksu.edu.sa.
authors.forename: Tariq I
authors.initials: TI
authors.lastname: Altokhais
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Alhanouf
authors.initials: A
authors.lastname: Al-Saleem
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulmonem
authors.initials: A
authors.lastname: Gado
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ayed
authors.initials: A
authors.lastname: Al-Qahtani
authors.affiliation: Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Al-Bassam
mesh_terms: D002648:Child; D002675:Child, Preschool; D004945:Esophagoscopy; D004947:Esophagus; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: children; esophageal foreign body; rigid esophagoscopy