• Wei Hao Lee, Zubin Grover, Meredith Borland, and Kunal Thacker.
• From the Princess Margaret Hospital for Children and Perth Children's Hospital, Perth, Australia.
• Pediatr Emerg Care. 2021 Aug 1; 37 (8): e464e467e464-e467.

ObjectiveEsophageal foreign body impaction (EFBI) is a common presentation in pediatric emergency medicine. Interventions (medical or endoscopic) are often required because of the severity of symptoms and risk of complications. Use of medical disimpaction (MD) such as glucagon injections and effervescent agents (eg, carbonated beverages) has been well described in adults; however, there are limited data in the pediatric literature. Eosinophilic esophagitis (EoE) is a relatively "new" clinicopathological entity that may present with EFBI mostly due to food with histological findings of EoE. Our study aim was to determine the efficacy of MD for organic EFBI in the pediatric population especially in children with EoE.MethodsA retrospective chart review was performed using the International Classification of Diseases codes and the emergency department database of patients presenting with EFBI from January 2010 to December 2014. Response to MD was defined as symptomatic relief of obstruction. Age, object ingested, medical agent used, EoE status, complications, and outcome were recorded.ResultsA total of 317 presentations of EFBI were identified during the study period, of which organic EFBI accounted for 101 impactions (31.9%). Medical disimpaction was attempted for 42 (41.6%) with organic EFBI, resulting in resolution of symptoms for 16 (38.1%). One child with EoE responded to MD compared with 15 without EoE (4.8% vs 71.4%, P < 0.0001).ConclusionsMedical disimpaction was ineffective in children with EoE but may be of help with symptom resolution in approximately 70% of children without EoE.Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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