Esophageal food bolus impaction in children: A 15-year experience and a review

Roberto Privato; Francesco Pezzoli; Simona Barni; Sara Renzo; Monica Paci; Jacopo Barp; Mattia Giovannini; Benedetta Pessina; Leonardo Tomei; Luca Scarallo; Paolo Lionetti; Francesca Mori

doi:10.1002/jpn3.12409

Esophageal food bolus impaction in children: A 15-year experience and a review

J Pediatr Gastroenterol Nutr. 2024 Nov 14. doi: 10.1002/jpn3.12409. Online ahead of print.

Authors

Roberto Privato¹, Francesco Pezzoli¹, Simona Barni², Sara Renzo³, Monica Paci³, Jacopo Barp³, Mattia Giovannini^{1

2}, Benedetta Pessina¹, Leonardo Tomei², Luca Scarallo^{3

4}, Paolo Lionetti^{3

4}, Francesca Mori²

Affiliations

¹ Department of Health Sciences, University of Florence, Florence, Italy.
² Allergy Unit, Meyer Children's Hospital, University of Florence IRCCS, Florence, Italy.
³ Gastroenterology and Nutrition Unit, Meyer Children Hospital IRCCS, Florence, Italy.
⁴ Department of NEUROFARBA, University of Florence, Florence, Italy.

PMID: 39543959
DOI: 10.1002/jpn3.12409

Abstract

Objectives: We aimed to analyze the episodes of esophageal food bolus impaction (EFI) occurred over a time of 15 years in children admitted to a large pediatric emergency department (PED), documenting their clinical presentation, underlying pathology, management, biopsy rate, and follow-up visits. Additionally, to combine our institutional experience with the existing literature, a comprehensive review was conducted.

Methods: We reviewed the medical records of all children presenting to our PED with EFI from 2010 to 2024. The comprehensive review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement for systematic reviews. Electronic databases including PubMed/Medline and EMBASE were screened. The data obtained was synthesized to map out the actual status and current literature on pediatric EFI.

Results: We identified 54 cases of EFI. Overall, 22 patients (41%) had underlying pathology. Previous episodes were reported in 14 cases (26%). Urgent endoscopy was performed in 31 cases (57%). The presence of underlying pathology was associated with the need for endoscopic removal (p = 0.013), as well as the history of previous episodes (p = 0.016). Biopsies were performed in 14 cases (26%). Pediatric gastroenterologists showed a higher rate of performed biopsies compared to surgeons, as well as higher rate of follow-up visits. An underlying disease was found during later clinical follow-up in 5 out of 54 cases of EFI (9%). A comprehensive review of 16 studies revealed high rates of underlying pathology and low rates of biopsies and follow-up visits among children with EFI.

Conclusion: Increased vigilance in identifying underlying pathologies in children with EFI is crucial. The importance of performing biopsies, regardless of prior anatomical conditions, and the need for ongoing follow-up to ensure timely and accurate diagnoses should be addressed through shared protocols.

Keywords: endoscopy; eosinophilic esophagitis; foreign body; pediatric.

Grants and funding

None