A safe alternative to endoscopic removal of blunt esophageal foreign bodies.

An alternative to the endoscopic removal of blunt esophageal foreign bodies is proposed. A Foley catheter is inserted into the esophagus and its balloon is utilized to extract the foreign body under fluoroscopic control. Experience with over 100 children with blunt esophageal foreign bodies has led us to conclude that the technique is easily performed, safe, and highly cost-effective. To protect the esophagus, care must be taken to ensure that the foreign body has no sharp or ragged edges, that it has been in place less than two weeks, and that there is no underlying esophageal disease. To ensure that no compromise of the airway occurs, several safeguards are employed, including orally inserting and withdrawing the catheter, monitoring the procedure fluoroscopically, and placing the patient in a prone oblique position with the fluoroscopic table steeply inverted.