Eosinophilic esophagitis in children needing emergency endoscopy for foreign body and food bolus impaction.

OBJECTIVE: The objective of this study was to examine the prevalence of eosinophilic esophagitis (EoE) in children presenting with esophageal foreign body (FB)/food bolus impaction.

METHODS: A retrospective chart review for all children who underwent endoscopic esophageal FB extraction at the Stollery Children's Hospital between January 2005 and December 2008 was performed. The prevalence of EoE and characteristics of children who had EoE were documented.

RESULTS: A total of 140 children (mean age, 4.98 [SD, 4] years; range, 0.3-16.9 years; 81 boys) had esophageal FB/food impaction and needed endoscopic removal over the study period. Eleven children (mean age, 9.38 [SD, 5.35] years; range, 1.9-16.2 years; 8 boys) were diagnosed with EoE (8%). Seven (39%) of 18 children with food impaction were diagnosed with EoE. Four (3%) of 122 children with esophageal foreign bodies other than food had EoE.

CONCLUSIONS: Considerable number of children with esophageal FB/food bolus impaction may have EoE. Routine sampling of esophageal mucosa at different levels during esophageal FB extraction may be considered. Well-designed prospective studies with multiple-level esophageal biopsies taken from all children with FB/food impaction are needed to confirm our results.