Endoscopic techniques and factors for complications in pediatric esophageal foreign body removal

Table 1 Variables related to esophageal foreign body intake, n (%)

Variable	n = 169
Impaction time (hours)
< 24	62 (37.3)
24-48	78 (47.0)
> 48	26 (15.7)
Location of the FB
Cervical esophagus	101 (60.8)
Thoracic esophagus	44 (26.5)
Abdominal esophagus	21 (12.7)
Nature of the FB
Inorganic	145 (87.3)
Organic	21 (12.7)
FB type
Coin	95 (57.2)
Battery	32 (19.3)
Food	20 (12.0)
Non-rechargeable battery	12 (7.2)
Bone	6 (3.6)
Needle	1 (0.6)

FB: Foreign body.

Table 2 Patients' symptoms after ingesting foreign body, n (%)

Symptom	n = 166
Dysphagia	42 (24.9)
Sialorrhea	39 (23.1)
Vomiting/regurgitation	28 (16.6)
Pain thoracic/retrosternal	17 (10.1)
Abdominal pain	9 (5.3)
Pain or cervical discomfort	8 (4.7)
Irritability	6 (3.6)
Asymptomatic	5 (3.0)
Stuck	3 (1.8)
Pain combined with other symptoms	23 (13.6)

Table 3 Endoscopic technique, need for surgery, clinical outcome and length of stay of pediatric patients with foreign bodies in the esophagus, n (%)

Variable	n = 166
Anesthesia
Sedation	148 (89.1)
General	18 (10.9)
Endoscopic technique
Flexible	84 (50.6)
Rigid	82 (49.4)
Endoscopic procedure
Successful	150 (90.4)
Unsuccessful	12 (7.2)
Pushed into the stomach	4 (2.4)
Surgical procedure
No	164 (97.0)
Yes	5 (3.0)
Clinical outcome
Hospital discharge	161 (97.0)
Death	5 (3.0)
LOS (days)
mean ± SD	2.6 ± 3.0

LOS: Length of stay.

Table 4 Factors related to complications from foreign bodies lodged in the esophagus, n (%)

Variable	Complications		P value1
	No, n = 107	Yes, n = 59
Impaction time (hours)			< 0.001
< 24	47 (43.9)	15 (25.4)
24-48	52 (48.6)	26 (44.1)
> 48	8 (7.5)	18 (30.5)
Location of the FB			< 0.001
Cervical esophagus	79 (73.8)	22 (37.3)
Thoracic esophagus	16 (15.0)	28 (47.5)
Abdominal esophagus	12 (11.2)	9 (15.3)
Nature of the FB			0.003
Inorganic	99 (92.5)	46 (78.0)
Organic	8 (7.5)	13 (22.0)
FB type			< 0.001
Coin	85 (79.4)	10 (16.9)
Battery	9 (8.4)	23 (39.0)
Food	8 (7.5)	12 (20.3)
Non-rechargeable battery	4 (3.7)	8 (13.6)
Bone	1 (0.9)	5 (8.5)
Needle	0 (0.0)	1 (1.7)

¹Fisher’s exact test; Wilcoxon rank-sum test; Pearson's χ² test.

FB: Foreign body.

Table 5 Efficacy of rigid and flexible endoscopes in treating esophageal foreign bodies, n (%)

Variable	Endoscopic procedure		P value1
	Flexible, n = 84	Rigid, n = 82
Endoscopic procedure			< 0.001
Successful	80 (95.2)	70 (85.4)
Pushed into the stomach	4 (4.8)	0 (0.0)
Unsuccessful	0 (0.0)	12 (14.6)
Surgical procedure			0.680
No	82 (97.6)	79 (96.3)
Yes	2 (2.4)	3 (3.7)
Clinical outcome			0.680
Hospital discharge	82 (97.6)	79 (96.3)
Death	2 (2.4)	3 (3.7%)
LOS (days)			0.060
mean ± SD	2.1 ± 1.8	3.2 ± 3.7
Complications			0.413
Mucosal edema	12 (14.3)	8 (9.8)
Mucosal erosion	14 (16.7)	12 (14.6)
None	54 (64.3)	53 (64.6)
Esophageal perforations	4 (4.8)	9 (11.0)

¹Fisher’s exact test; Wilcoxon rank-sum test; Pearson's χ² test.

LOS: Length of stay.

Table 6 Analysis of the clinical outcome of children who underwent upper digestive endoscopy for impacted foreign body in the esophagus, n (%)

Variable	Clinical outcome		P value1
	High, n = 161	Death, n = 5
Endoscopic technique			0.680
Flexible	82 (50.9)	2 (40.0)
Rigid	79 (49.1)	3 (60.0)
Endoscopic procedure			0.004
Successful	148 (91.9)	2 (40.0)
Pushed into the stomach	4 (2.5)	0 (0.0)
Unsuccessful	9 (5.6)	3 (60.0)
Surgical procedure			< 0.001
No	161 (100.0)	0 (0.0)
Yes	0 (0.0)	5 (100.0)
LOS (days)			0.017
mean ± SD	2.6 ± 2.7	3.6 ± 8.0
Complications			< 0.001
Mucosal edema	20 (12.4)	0 (0.0)
Mucosal erosion	26 (16.1)	0 (0.0)
None	107 (66.5)	0 (0.0)
Esophageal perforations	8 (5.0)	5 (100.0)

¹Fisher's exact test; Wilcoxon rank sum test.

LOS: Length of stay.