Simple Removal Method of Esophageal Blunt Foreign Bodies

Kim,  Seung Yul

J Korean Soc Emerg Med > Volume 14(3); 2003 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2003;14(3): 251-257.

Simple Removal Method of Esophageal Blunt Foreign Bodies

Seung Yul Kim

Emergency Department, Ulsan Dong-gang Hospital, Ulsan, Korea. notwho@daum.net

ABSTRACT

PURPOSE:
Patients with esophageal foreign bodies are difficult to treat in an emergency room. Conventional endoscopic and fluoroscopy guide Foley's catheter removal methods are time consuming, expensive, and often not even possible in an emergency room. To resolve this difficulty, Thus I sought an alternative simple method using Foley's catheter without fluoroscopy.
METHODS:
I reviewed retrospectively patients with esophageal blunt foreign bodies. The subjects consisted of 40 patients who had been treated with a Foley's catheter without fluoroscopy from May 2000 to December 2002 at the emergency room.
RESULTS:
Of all 40 cases, 27 patients had foreign bodies lodged in the first esophageal constrictor; 10 patients in the second; and 3 patients in the third. The success rate was 40/40 (100%). In 36 patients, the foreign bodies were removed at the first try. In the remaining 4 patients, they were removed at the second try. Side effects were crying (36 cases), vomiting (18 cases), slightly bloody vomitus (12 cases), sore throat (12 cases), slightly nasal bleeding (6 cases). No serious complications were observed. The average time of removal was 38 minutes. The quickest removal was done in 10 minutes; the longest in 58 minutes.
CONCLUSIONS:
The simple Foley's catheter removal method is a safe, cost-effective and time-saving method, and does not require the use of endoscopy or fluoroscopy. Moreover, minimal training is required to perform the procedure. Compared to conventional methods, the technique is equally effective and avoids the risk of general anesthesia. The possibility of an esophageal coin foreign body developing into a serious complication may be time-dependent (how fast a patient is treated) rather than the modality-dependent.