Value and Efficacy of Foley Catheter Removal of Blunt Pediatric Esophageal Foreign Bodies

Objective. To discuss the safety and efficacy of Foley catheter removal of blunt pediatric esophageal foreign bodies. Methods. Analyzing our first 17 cases of pediatric esophageal foreign bodies removed by Foley catheter method in respect of the efficacy, removal methods, and complications. We also reviewed related literature and discussed the background, current status, and technical matters that need attention of this method. Results. In three-year period between May 2010 and May 2013, in 16 out of 17 children blunt radiopaque foreign bodies impacted in the esophagus were successfully removed by a Foley catheter. There were no complications. In one patient, the foreign body was advanced into stomach and came out with stool 2 days later. Conclusions. The technique is safe, rapid, and cost-effective procedure and applicable for blunt, flat foreign bodies impacted in the esophagus. 1. Introduction Children have a natural tendency to put any small objects into their mouth; occasionally these objects can be ingested in the airodigestive tract; 80% of them will be stuck in the esophagus and 20% of them will lodge in the airway. In China, no statistical data on the incidence of esophageal foreign body is available, while the American Association of Poison Control documented 182,105 incidents of foreign body ingestion by patients younger than 20 years in 1999 [1, 2]. In most cases, an impacted esophageal foreign body is an urgent medical situation. The majority of patients with esophageal foreign bodies are children. Unlike adults, the most common pediatric esophageal foreign bodies are blunt and round objects like coins, buttons, or button batteries. The conventional method involves removal of the foreign body under direct vision using a rigid esophagoscope under general anesthesia. In fact, the majority of blunt pediatric esophageal foreign bodies can be removed by a nonoperative Foley catheter removal. In this report we describe our experience of first 17 cases removing blunt radiopaque esophageal foreign bodies by a Foley’s catheter without fluoroscopic guidance. 2. Materials and Methods We evaluated the safety and efficacy of the Foley catheter technique by identifying detailed records of our first 17 cases that had undergone a Foley catheter removal of blunt radiopaque foreign bodies from May 2010 to May 2013. 2.1. Procedure The materials needed for foreign body removal include a number of 14 to 18 Foley catheters, a 10？mL syringe, tongue depressor, and saline water. Additionally, pediatric direct laryngoscope, rigid esophagoscope and bronchoscope,