What Is Pediatric Dysphagia?

Pediatric esophageal foreign bodies are caused by children who like to play in their mouths and accidentally swallow them. Common foreign objects are coins, buttons, micro batteries, pins, plastic covers, bone fragments, date cores, and so on. Because the esophagus is a muscular tube with greater elasticity, most of the foreign matter that enters the esophagus can be sent into the stomach with swallowing peristalsis. Most of the foreign matter that remains in the esophagus are large and irregularly shaped sharp foreign bodies. Generally, it remains in the first stenosis of the esophagus, and it can also stay in the second stenosis of the thoracic segment, which is equivalent to the level of the aortic arch. Few foreign bodies stay in the lower section.

Basic Information

Visiting department

Otorhinolaryngology head and neck surgery

Multiple groups

Infants

Common locations

esophagus

Common causes

Inadvertently slip into the hypopharynx and enter the esophagus while chewing; eat into the esophagus by mouth or playing equipment

Common symptoms

Pharyngeal or esophageal nausea, painful swallowing, salivation, difficulty in eating, vomiting, milk rejection, etc .; hoarseness, cough, wheezing, difficulty breathing when foreign bodies are large

Etiology of esophageal foreign bodies in children

The causes of esophageal foreign bodies can be divided into two categories:

1. When eating and chewing, accidentally slip into the hypopharynx and enter the esophagus, such as fishbone or chicken bone.

2. The child accidentally swallows the esophagus contained in the mouth or playing equipment, such as coins, button batteries, paper clips and various sharp foreign objects.

Clinical manifestations of esophageal foreign bodies in children

Most of them have a history of swallowing foreign bodies. Children who swallow foreign bodies initially show a clear pharyngeal or esophageal nausea, swallowing pain, salivation, difficulty eating, vomiting, and milk rejection. Esophageal mucosa may spit bleeding when there is a laceration. Infants manifest as crying, aspiration and larger foreign bodies press the back wall of the trachea forward or when the foreign body is high and does not fully enter the esophageal compression throat, causing hoarseness, coughing, wheezing, difficulty breathing and even suffocation.

Pediatric esophagus foreign body examination

Laboratory inspection

With concurrent infections, peripheral white blood cell counts and neutrophils increase.

2.X-ray inspection

It is the main method for the diagnosis of foreign body in esophagus. It can not only clarify the characteristics and location of foreign body in esophagus, but also an important method to diagnose whether esophageal perforation is combined. X-ray radiographs of foreign bodies can be displayed on radiographs of the neck and chest. If foreign bodies are suspected of not being developed, esophageal angiography can be performed, and most of them can confirm the diagnosis. Patients with esophageal perforation at the same time can show free gas in cervical tissue, anterior vertebral soft tissue widens due to inflammation, and trachea moves forward.

3. Esophageal endoscopy

Those who are clearly identified as foreign bodies in the esophagus can directly undergo esophageal endoscopy and try to remove the foreign bodies.

Pediatric esophageal foreign body diagnosis

Diagnosis is mainly based on a history of mistaken swallowing foreign bodies, clinical symptoms, and radiological examinations.

Pediatric esophageal foreign body treatment

Once the foreign body in the esophagus is diagnosed, the foreign body needs to be removed with an esophagoscopy. If the foreign body is embedded in the esophagus wall or out of the esophagus, it should be removed by surgery. For esophageal foreign body comorbidities, timely symptomatic and appropriate treatment, such as anti-infection treatment.

Prognosis of esophageal foreign body in children

The prognosis is good after removing the foreign body (battery). If the foreign body is a battery, the alkaline substance continues to corrode and fatal bleeding and pneumothorax occur.

Pediatric esophageal foreign body prevention

Foreign bodies in the esophagus are completely preventable, and education should be widely conducted to parents and caregivers, mainly to strengthen infant and child care.

1. Don't eat too quickly, especially when eating thorny foods, you must chew carefully to spit out the bone spurs.

2. Educate children to correct the bad habit of playing with coins, batteries, and toys in their mouths.

3. After swallowing the foreign body by mistake, avoid forcibly removing the foreign body with rice, steamed bread, leeks and other methods.