Objective: To prove safety, efficacy, cost effectiveness and reduced hospital stay with Foley balloon extraction of esophageal coins. Design: A cohort, interventional study. Place and Duration of Study : The study was conducted at the Department of Pediatric Surgery, National Institute of Child Health, Karachi from October 2001 to August 2002. Patients and Methods: A total of 50 patients with upper esophageal coins diagnosed on the basis of radiographs were included in the study. They were primarily subjected to Foley balloon extraction without any anesthesia or analgesia. Results: In 41(82%) cases Foley balloon extraction was successful and coins were extracted. One patient did not cooperate. He was subjected to endoscopy. Procedure failed in 8 patients. During extraction with balloon, 3 (6%) coins slipped into the stomach, and these were subsequently passed in stool. In 5 (10%) cases coins remained impacted, 4 of which were subsequently removed using Magill forceps under general anesthesia while in one case coin slipped into the stomach during the procedure. The only complication was slight nose bleed in 5 (10%) cases, which stopped spontaneously. Success of method was not related with patient`s age, sex and type of coin. Conclusion: Foley balloon extraction is a safe, efficient, cost effective method of management of esophageal coins coupled with reduced hospital stay.
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