Use of Magill Forceps to Remove Foreign Bodies in Children

Abstract

Accidental foreign body (FB) ingestion is a common clinical problem.1 FB ingestion is highly prevalent among the pediatric age group. In adults, it occurs most frequently in alcoholics, prisoners, and those with mental retardation. 2,3Radiological localization of ingested FB using advanced techniques is mandatory. 4 Esophagoscopy is the main method for the removal of FBs. Rigid esophagoscopy has been mainly associated with a 5 and 10% risk of perforation during FB removal. The ideal methods are all of the procedures which have lower perforation rate to quickly remove the FBs. Foley catheter extraction and the minimally invasive Magill forceps devices were described for this goal to remove FBs which located in the upper esophagus. The present study aimed to report our experience retrieving ingested FBs from the upper esophagus in children using Magill forceps under general anesthesia. Materials and MethodsIn total, 88 patients (45 (1) coins, (2) toys, (3) metals, (4) bones, (5) battery, (6) glass, and (7) food. A laryngoscope was used to elevate the larynx and expose the esophageal entrance. Magill forceps were advanced into the esophagus and opened to observe and extract the FB.Results All 88 patients who underwent endoscopic examination due to suspected FB ingestion were confirmed to have ingested a FB. Median age was 12 years; 15 patients were aged < 5 years; 63 (71.5%) were diagnosed based on routine radiographic findings, and others were diagnosed based on physical findings and history. The most common type of FB was coins (n ¼ 51 [57.9%]). Mean surgical duration was 20 minutes. Conclusion FBs located at cervical esophageal level are usually the most difficult to remove. Magill forceps should be used before other methods.

Rapid and safe removal of foreign bodies in the upper esophagus in children using an optimized Miller size 3 video laryngoscope blade

“…However, no clear recommendations on endotracheal intubation or other details are available. 15,18 Only two statements on the issue of anesthesia appear to be significant: It should be provided as fast as possible and by an anesthetist with pediatric expertise. 10 As we deliberately did not define a standardized anesthesia technique regarding drugs used and the instrumentation of the airway, we observed that in one center, general anesthesia was never accompanied by endotracheal intubation or usage of a neuromuscular blocking agent.…”

Thoracic esophageal perforation by the use of Magill forceps in infant, success with non-operative treatment: case report

“…Unfortunately, the ENT team made a poor management decision at the time. However, a perforation induced by Magill forceps is exceptional [1,2,6]. Some ENT teams are used to extract foreign bodies from the cervical esophagus using Magill's forceps with great success and little or no complication [6].…”

“…However, a perforation induced by Magill forceps is exceptional [1,2,6]. Some ENT teams are used to extract foreign bodies from the cervical esophagus using Magill's forceps with great success and little or no complication [6]. The average of delay diagnosis for esophageal iatrogenic perforations in infants is 1.4 days (0-2 days) [7].…”

A complication during endoscopic removal of a long esophageal foreign body in an eight-month-old girl

“…A variety of therapeutic procedures to remove esophageal foreign bodies has been described. These include flexible and rigid endoscopy, Foley catheter extraction, bougienage, and the use of Magill forceps [9,10,11]. Flexible endoscopy under general anesthesia is the therapeutic procedure of choice because the foreign body can be directly removed and the esophagus can be examined for potential complications and other pathology [1].…”

“…Of the 28 patients, 22 had ingested fish or poultry bones, and the rest had ingested glass or metal objects. In a recently published article, Turkish authors reported very good clinical experience in removal of different foreign bodies from proximal esophagus by Magill forceps in almost all of the 88 pediatric patients [11].…”