Esophageal Foreign Bodies in Infants and Children
- Most esophageal foreign bodies occur in children younger than 5 years of age.
- Impaction occurs at areas of anatomic narrowing (e.g., the cricopharyngeus) or strictures.
- Coins are the most common esophageal foreign body.
- Disc or button batteries are true emergencies and can lead to stricture, perforation, and death.
- Two or more magnets can attract each other through a loop of bowel leading to perforation. Rapid removal of magnets (may leave one behind) is essential.
- Anteroposterior (AP) and lateral radiography of the neck and chest, and AP of the abdomen are essential.
- Rigid esophagoscopy is the safest method of removing a foreign body.
The ingestion of foreign bodies into the aerodigestive tract is a relatively common phenomenon in children younger than 3 years of age because children explore their environment through oral and tactile means, have sparse dentition, and lack the cognitive ability to distinguish food from inedible objects. Approximately 75% of ingested foreign bodies are lodged in the esophagus, and the remainder are found in the laryngotracheobronchial tree. Resulting symptoms depend on the site and level of impaction, size of the object, and whether the object is corrosive or sharp. Smaller, smooth objects such as coins may remain in situ for days or weeks with minimal consequence, whereas foreign bodies that can penetrate the mucosa can rapidly cause death from hemorrhage or mediastinitis.
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