Point-of-care ultrasonography in the detection of pediatric esophageal food impaction

Laura Anna Simone; Jonathan Orsborn; Ron Berant; Mark O. Tessaro

doi:10.1016/j.ajem.2015.08.020

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Point-of-care ultrasonography in the detection of pediatric esophageal food impaction☆☆☆

Laura Anna Simone, MD

Paediatric Emergency Medicine, Hospital for Sick Children, Toronto, ON, Canada, M5G 1X8

Jonathan Orsborn, MD

Pediatric Emergency Medicine, Arkansas Children's Hospital, Little Rock, AR 72202

Ron Berant, MD

Emergency Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel, 49202

Mark O. Tessaro, MD

Paediatric Emergency Medicine, Hospital for Sick Children, Toronto, ON, Canada, M5G 1X8

DOI: http://dx.doi.org/10.1016/j.ajem.2015.08.020

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Fig. 1

Transverse views of the anterior neck just superior to the sternal notch in a 10-year-old boy with impacted chicken food bolus. A, The esophagus (arrow) is dilated by mixed echogenicity contents. B, After spontaneous passage of the impacted food, the esophagus exhibits a normal appearance of multiple concentric layers (arrow).

Fig. 2

Transverse views of the anterior neck just superior to the sternal notch in a 10-year-old girl with impacted steak food bolus. A, The esophagus contains hyperechoic air signal (arrow) with dirty shadowing that obscures the posterior esophageal wall. This appearance did not change with swallowing efforts. B, After vomiting of the impacted food, the esophagus exhibits a normal oval appearance, and the posterior wall (arrow) is visualized.

Fig. 3

Transverse view of the anterior neck just superior to the sternal notch in a 6-year-old boy with impacted cervical esophageal bone marrow. A, The esophagus is dilated by mixed echogenicity contents (arrow). B, Piece of bone marrow retrieved from the cervical esophagus in the operating room.

Fig. 4

Ultrasound technique. The transducer is held perpendicular to the anterior neck, and swept between the larynx and suprasternal notch.

Esophageal food impaction in children occurs most commonly at the level of the thoracic inlet, where ultrasonography of the anterior neck can visualize the esophagus. We describe a series of cases in which point-of-care ultrasound by pediatric emergency physicians was used to diagnose esophageal food impaction. This novel technique may expedite diagnosis for children with this distressing condition.

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☆Source(s) of support: None.

☆☆Article presentations: None.

Point-of-care ultrasonography in the detection of pediatric esophageal food impaction☆☆☆

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