Mi Jin Lee, Tae-Yong Shin, Chang Hee Lee, Jun dong Moon, Sang Gyun Roh, Chan Woong Kim, Hyo Eun Park, Seon Hee Woo, Seung Joon Lee, Seung Lyul Shin, Young Taeck Oh, Yong Su Lim, Jae Young Choe, Sang-Hoon Na, Sung Oh Hwang, on behalf of the Steering Committee of 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Clin Exp Emerg Med 2021;8(S):S116-S124. Published online May 21, 2021
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Objective This study aimed to determine the factors that affect successful esophageal foreign body (FB) removal using a Foley catheter and to identify methods to increase the success rate.
Methods In this retrospective, cross-sectional study, we included pediatric patients who presented with esophageal FB impaction that was removed using a Foley catheter in the emergency departments of tertiary care and academic hospitals. We analyzed the effect of the patients’ age, sex, and symptoms; FB type, size, and location; Foley catheter size; complications during FB removal; duration between FB ingestion and removal; operator’s years of training; sedation; success rate of FB removal; endoscopy; and patient’s posture during FB removal on the success of Foley catheter-based FB removal.
Results Of the 43 patients we enrolled, Foley catheter-based FB removal was successful in 81.4% (35/43) but failed in 18.6% (8/43) of patients; no FB-removal-related complications were reported. There was no significant association between the success rate of Foley catheter-based FB removal and any study variable. A higher number of years in training tended to increase the success rate of Foley catheter-based FB removal, although statistical significance was not achieved.
Conclusion Children’s esophageal FB removal is a practical challenge in the emergency rooms, and using a Foley catheter is associated with a high success rate of the removal and low occurrence of complications. In this study, no single variable was found correlated with the success rate of Foley catheter-based esophageal FB removal in pediatric patients, which may indicate multiple variables interacting with one another to affect the success rate.
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Predictive validity of resource-adjusted Korean Triage and Acuity Scale in pediatric gastrointestinal tract foreign body patients Jin Hee Lee, Jin Hee Jung, Hyun Noh, Mi Jin Kim Scientific Reports.2024;[Epub] CrossRef
Descending necrotizing mediastinitis (DNM) is a rare form of mediastinal infection. Most cases are associated with esophageal rupture. DNM after a trigger point injection in the upper trapezius has not been described previously. We present a case of DNM after a trigger point injection in the upper trapezius. A 70-year-old man visited the emergency department with chest discomfort and fever after a trigger point injection in the left upper trapezius. Chest computed tomography showed evidence of DNM, and antibiotic therapy was immediately administered intravenously. Because of the risk of sudden death, poor prognosis due to underlying disease, and his age, he declined surgical treatment and died of septic shock. Although trigger point injections are generally considered safe, caution should be used in patients with an underlying disease or in the elderly. Early diagnosis, broad-spectrum antibiotics, and aggressive surgical management are essential to improve the prognosis.
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