Pediatr Gastroenterol Hepatol Nutr.  2019 Mar;22(2):132-141. 10.5223/pghn.2019.22.2.132.

Foreign Body Removal in Children Using Foley Catheter or Magnet Tube from Gastrointestinal Tract

Affiliations
  • 1Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 2Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea. bhchoe@knu.ac.kr

Abstract

Foreign body (FB) ingestion of children is a common pediatric emergency requiring medical attention. Pediatric emergency physicians and gastroenterologists often encounter nervous and distressed situations, because of children presenting with this condition in the common clinical practice. When determining the appropriate timing and indications for intervention, physicians should consider multiple patient- and FB-related factors. The utilization of a flexible endoscopy is considered safe and effective to use in these cases, with a high success rate, for the effective extraction of FBs from the gastrointestinal tract of a child. Additionally, a Foley catheter and a magnet-attached Levin tube have been used for decades in the case of FB removal. Although their use has decreased significantly in recent times, these instruments continue to be used for several indications. Using a Foley catheter for this purpose does not require special training and does not necessarily require sedation of the patient or fluoroscopy, which serve as advantages of utilizing this method for foreign object retrieval. An ingested magnet or iron-containing FB can be retrieved using a magnet-attached tube, and can be effective to retrieve an object from any section of the upper gastrointestinal tract that can be reached. Simple and inexpensive devices such as Foley catheters and magnet-attached tubes can be used in emergencies such as with the esophageal impaction of disk batteries if endoscopy cannot be performed immediately (e.g., in rural areas and/or in patients presenting at midnight in a facility, especially in those without access to endoscopes or emergency services, or in any situation that warrants urgent removal of a foreign object).

Keyword

Foreign bodies; Foley catheterization; Magnets; Endoscopy; Esophagus; Children

MeSH Terms

Catheters*
Child*
Eating
Emergencies
Endoscopes
Endoscopy
Esophagus
Fluoroscopy
Foreign Bodies*
Gastrointestinal Tract*
Humans
Methods
Upper Gastrointestinal Tract
Urinary Catheterization

Figure

  • Fig. 1 The image shows disk battery impaction in the upper esophagus of a 23-month-old infant, causing adjacent ulcers and surrounding mucosal edema in the patient. The battery could not be removed despite several trials using various devices including a rigid esophagoscope, a flexible pediatric endoscope with a pediatric rat-tooth grasping forceps, a larger adult-size endoscope with pelican type grasping forceps, as well as the prior unsuccessful attempts to push it further into the stomach. The outer cap of the device used for endoscopic variceal ligation was applied at the end of an adult endoscope, which was used concomitantly with the pelican-type grasping forceps, to successfully extract the disk battery from the infant.

  • Fig. 2 (A) Disk battery impacted at mid esophagus in 24 months-old infant. It could not be grasped by forcep because it was partially embedded under the esophageal wall. It could be removed out of esophageal wall by repetitive rubbing of endoscope with disk battery and removed using retrieval net. (B) After removal of the impacted battery, this boy was admitted to intensive care unit to treat mediastinitis. The follow-up endoscopy revealed trachea-esophageal fistula.

  • Fig. 3 Magnetic tip Levine tube.


Cited by  1 articles

Safety and Competency are the Main Priorities in Pediatric Endoscopy
Byung-Ho Choe
Clin Endosc. 2020;53(4):379-380.    doi: 10.5946/ce.2020.124.


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