Printer Friendly

Esophageal food impaction in children: two cases of unusual causes.

Esophageal food impaction is rare in normal children. This problem is most frequently seen in adults and is rarely seen in children. In adults most patients have underlying esophageal disorder or from undiagnosed illness. A 15-year-old male presented with chest pains during dinner after eating a piece of meat. He had some mild dyspnea. PMH was remarkable for tracheoesophageal fistula (TEF) repair in the newborn period, dextrocardia, and asthma. He took omeprazole and fluticasone/salmeterol diskus. His physical examination was unremarkable. His esophagram revealed an irregular intraluminal filling defect in the distal one third of the esophagus. He was taken to the operating room and was found to have an esophageal stricture and the stricture was resected with primary reanastomosis. A 13-year-old female presented after ingestion of a hot-dog mid chest pains, cough and dysphagia. ROS revealed her to be falling backwards and progressive upper extremity weakness during the day. PMH was unremarkable. Neurologic exam showed a motor strength 2/5 in the upper extremity, normal sensation, reflexes and cranial nerves. She had dysmetria. Her esophagram showed an irregular intraluminal filling defect in the distal esophagus. She was given an edrophonium test and her symptoms improved. She was admitted for the new diagnosis of Myasthenia gravis. The hot dog passed on its own and she was discharged on pyridostigmine. Esophageal strictures have been a known complication of TE fistula repair and the presence of food impaction should exclude an underling stricture. Appropriate management is removal of the impaction and resection or dilation of the stricture. Myasthenia gravis as a cause of food impaction in children has not been described, but these patients are at increased risk. With a careful review of symptoms and exam this entity can easily be diagnosed and appropriate therapy instituted to prevent further morbidity.

Antonio E. Muniz, MD, Chris Woleben, MD, Sam Bartle, MD, Robin L. Foster, MD, and Steve Liner MD. Department of Emergency Medicine and Pediatrics, Virginia Commonwealth University Medical Center, Richmond, VA.
COPYRIGHT 2004 Southern Medical Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2004, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:Section on Family Practice
Author:Liner, Steve
Publication:Southern Medical Journal
Date:Oct 1, 2004
Previous Article:Adding Bariatrics to your medical practice.
Next Article:Recurrent carcinoid twenty-two years following bronchial carcinoid resection.

Related Articles
Evaluating Diagnosis and Treatment of Oral and Esophageal Candidiasis in Ugandan AIDS Patients.
CA4 Esophageal impaction presenting as an ST segment elevation myocardial infarction. (Cardiology).
RAD6 Esophageal perforation: A pictorial review of a sinister condition. (Radiology).
Cervical esophageal foreign body. (Esophagoscopy Clinic).
Thoracic esophageal perforations. (Original Article).
Black esophagus. (Original Article).
Esophageal perforation and neck abscess from ingested foreign bodies: treatment and outcomes.
Esophageal foreign body aspiration presenting as asthma in the pediatric patient.
Eosinophilic esophagitis.
Dysphagia in a HIV patient: concern for the etiology?

Terms of use | Copyright © 2018 Farlex, Inc. | Feedback | For webmasters