Coins in the Esophagus: A Departure from Conventional Therapy

Aiken, David Wyatt

doi:10.1093/milmed/130.2.182

Cited by 13 publications

(3 citation statements)

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“…We performed this study to identify the role of radiology in the diagnosis, treatment, [4,5], and pediatric radiologists became involved in the treatment as well as the diagnosis of esophageal foreign bodies [6,7]. Although this technique offers a fast, effective, and inexpensive alternative to esophagoscopy, some controvemsy exists about its safety [8].…”

Section: Objectivementioning

confidence: 99%

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Macpherson¹,

Hill²,

Othersen³

et al. 1996

American Journal of Roentgenology

113

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Section: Objectivementioning

confidence: 99%

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Macpherson¹,

Hill²,

Othersen³

et al. 1996

American Journal of Roentgenology

113

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“…The technique for esophageal bougienage was first described by Aiken 21 in 1965 using a lubricated Levine tube. Since its initial description, a number of studies, 2,[22][23][24][25][26][27][28] including one from our own site, 27 have reported on the safety and efficacy of esophageal bougienage, as well as its reduced cost and length of stay (LOS) relative to endoscopic removal.…”

mentioning

confidence: 99%

Esophageal Bougienage for Management of Lodged Esophageal Coins

Warner¹,

Genereux

Price

et al. 2022

Pediatr Emer Care

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Objectives:The aims of the study are to evaluate outcomes of esophageal bougienage for management of lodged esophageal coins and to assess the extent of bougienage usage and barriers among emergency providers. Methods:We performed a retrospective chart review of pediatric patients with single lodged esophageal coins presenting to our single academic pediatric emergency department between November 2012 and December 2018. We compared procedural outcomes, complications, length of stay (LOS), and cost between those managed with bougienage and with endoscopy. We further surveyed emergency physicians to assess the extent of bougienage usage and barriers to utilization across different institutions. Results:We identified 205 patients with single lodged esophageal coins presenting during our study window. One hundred forty-seven patients ultimately underwent bougienage with 97% success and no major complications. Fifty-six patients were managed by endoscopy with 100% success and one major complication. Bougienage had significantly lower LOS (median 2.18 vs 11.92 hours, P < 0.001) and hospital charges (median $3533 vs $12,679, P < 0.001) compared with endoscopy. We received 242 completed surveys representing 38 states from primarily academic pediatric emergency physicians. The majority of respondents (90%) used specialist consult with only 4.5% performing bougienage. A total of 36.4% of respondents had never heard of the procedure and only 16.1% had ever performed it. Barriers to usage included lack of provider training (95.6%), perceived risk of complications (94.4%), and perceived lack of success (80.5%). Conclusions:Bougienage is safe and effective with significant LOS and cost benefits compared with endoscopy. Despite these advantages, the procedure is underused, because of lack of provider education and concerns regarding safety, efficacy, and both family and specialist preference, which are not supported by current literature. These data support the need for broader education regarding the bougienage technique, as well as larger prospective studies of its safety and outcomes.

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“…With development of the esophagoscope and modern anesthesia, endoscopic removal became the preferred mode of treatment [4]. In the 1960's surgeons began reporting their successes in removing esophageal foreign bodies in children utilizing a Foley catheter in order to avoid the potential hazards of general anesthesia and endoscopy (5)(6)(7)(8). Utilization of this form of treatment has steadily increased nationwide, particularly among radiologists, so that a substantial amount of experience has now been accumulated.…”

mentioning

confidence: 99%

Catheter removal of blunt esophageal foreign bodies in children

Campbell

Condon

1989

Pediatr Radiol

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The membership of the Society for Pediatric Radiology was surveyed to determine the safety and efficacy of the Foley catheter technique. Completed questionnaires were returned from 148 institutions. Sixty-four institutions reported that they were currently removing blunt esophageal foreign bodies utilizing the balloon catheter. Over 2500 patients were reported as having been treated utilizing this technique. Only one potentially serious but reversible complication was observed.

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Coins in the Esophagus: A Departure from Conventional Therapy

Cited by 13 publications

References 0 publications

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Esophageal foreign bodies in children: diagnosis, treatment, and complications.

Esophageal Bougienage for Management of Lodged Esophageal Coins

Catheter removal of blunt esophageal foreign bodies in children

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