Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
Pediatric Department, Santobono-Pausilipon Children's Hospital, Naples, Italy.
J Pediatr Gastroenterol Nutr. 2024 Jun;78(6):1398-1402. doi: 10.1002/jpn3.12222. Epub 2024 Apr 16.
Esophageal food impaction (EFI) is the sudden onset of dysphagia that occurs when a food bolus becomes lodged in the esophagus, requiring endoscopic removal. Scientific data on the prevalence and causes of EFI in children is lacking. The aim of this study was to provide further insights into EFI episodes in children.
We have prospectively enrolled all children admitted for a first episode of EFI between March 2018 and March 2023. A fluoroscopic contrast study was performed in all patients to confirm the boluses and assess their position. Boluses were extracted by esophagogastroduodenoscopies, and esophageal biopsies were routinely obtained for histologic evaluation.
Over the study period, 41 children were admitted for a first episode of food impaction. Drooling was the most commonly reported symptom. Half children experiencing a first episode of food bolus were diagnosed with EoE (20/41, 48.8%). Almost a fourth of the episodes subtended a different condition, such as esophageal anastomotic, peptic or congenital strictures, stricturing caustic esophagitis, esophageal duplication, and achalasia. In the last fourth of patients the cause of EFI was not identified and thus probably related to quick eating and inadequate chewing of food.
Our study represents the largest known series of pediatric patients evaluated for food bolus impaction. Our main finding is the high frequency of EoE, which accounts for a half of EFI episodes in pediatric age, especially in older children. This finding highlights the importance of obtaining esophageal biopsies after the endoscopic bolus removal in children with EFI to provide a complete diagnostic evaluation.
食管食物嵌塞（EFI）是指食物团块突然嵌顿在食管中导致的吞咽困难，需要通过内镜取出。目前缺乏关于儿童 EFI 患病率和病因的科学数据。本研究旨在进一步了解儿童 EFI 发作的情况。
我们前瞻性纳入了 2018 年 3 月至 2023 年 3 月期间因首次 EFI 入院的所有儿童。所有患者均进行荧光透视对比研究以确认嵌塞物并评估其位置。通过食管胃十二指肠镜取出嵌塞物，并常规获取食管活检进行组织学评估。
在研究期间，41 名儿童因首次食物嵌塞而入院。流涎是最常见的报告症状。首次出现食物嵌塞的儿童中有一半被诊断为 EoE（20/41，48.8%）。近四分之一的病例为其他情况，如食管吻合口、消化性或先天性狭窄、腐蚀性食管炎狭窄、食管重复畸形和贲门失弛缓症。在最后四分之一的患者中，EFI 的病因未被确定，可能与快速进食和食物咀嚼不充分有关。
我们的研究代表了已知最大的儿科患者食物嵌塞评估系列。我们的主要发现是 EoE 的高频率，其占儿科年龄 EFI 发作的一半，尤其是在大龄儿童中。这一发现强调了在儿童 EFI 内镜下取出嵌塞物后获取食管活检的重要性，以提供完整的诊断评估。
