{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T18:40:08Z","timestamp":1746384008199,"version":"3.40.4"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The aims of the study are to evaluate outcomes of esophageal bougienage for management of lodged esophageal coins and to assess the extent of bougienage usage and barriers among emergency providers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed a retrospective chart review of pediatric patients with single lodged esophageal coins presenting to our single academic pediatric emergency department between November 2012 and December 2018. We compared procedural outcomes, complications, length of stay (LOS), and cost between those managed with bougienage and with endoscopy. We further surveyed emergency physicians to assess the extent of bougienage usage and barriers to utilization across different institutions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We identified 205 patients with single lodged esophageal coins presenting during our study window. One hundred forty-seven patients ultimately underwent bougienage with 97% success and no major complications. Fifty-six patients were managed by endoscopy with 100% success and one major complication. Bougienage had significantly lower LOS (median 2.18 vs 11.92 hours, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) and hospital charges (median $3533 vs $12,679, <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001) compared with endoscopy. We received 242 completed surveys representing 38 states from primarily academic pediatric emergency physicians. The majority of respondents (90%) used specialist consult with only 4.5% performing bougienage. A total of 36.4% of respondents had never heard of the procedure and only 16.1% had ever performed it. Barriers to usage included lack of provider training (95.6%), perceived risk of complications (94.4%), and perceived lack of success (80.5%).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Bougienage is safe and effective with significant LOS and cost benefits compared with endoscopy. Despite these advantages, the procedure is underused, because of lack of provider education and concerns regarding safety, efficacy, and both family and specialist preference, which are not supported by current literature. These data support the need for broader education regarding the bougienage technique, as well as larger prospective studies of its safety and outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002849","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T15:00:11Z","timestamp":1664463611000},"page":"589-597","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Esophageal Bougienage for Management of Lodged Esophageal Coins"],"prefix":"10.1097","volume":"38","author":[{"given":"Tessa N.","family":"Warner","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeline","family":"Genereux","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Department of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda B.","family":"Price","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Olivia","family":"Titus","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew M.","family":"Moake","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/PEC.0b013e31826248eb","article-title":"Children will eat the strangest things: a 10-year retrospective analysis of foreign body and caustic ingestions from a single academic center","volume":"28","year":"2012","journal-title":"Pediatr Emerg Care"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.annemergmed.2007.09.001","article-title":"Safety and efficacy of a protocol using bougienage or endoscopy for the management of coins acutely lodged in the esophagus: a large case series","volume":"51","year":"2008","journal-title":"Ann Emerg Med"},{"key":"bib3-20250504","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1097\/01.pec.0000225275.20735.69","article-title":"Management of esophageal coins","volume":"22","year":"2006","journal-title":"Pediatr Emerg Care"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.jpedsurg.2006.01.022","article-title":"Esophageal foreign bodies in the pediatric population: our first 500 cases","volume":"41","year":"2006","journal-title":"J Pediatr Surg"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1016\/S0022-3468(99)90106-9","article-title":"Foreign-body ingestion in children: experience with 1,265 cases","volume":"34","year":"1999","journal-title":"J Pediatr Surg"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/01.pec.0000177196.83655.91","article-title":"Witnessed and unwitnessed esophageal foreign bodies in children","volume":"21","year":"2005","journal-title":"Pediatr Emerg Care"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/000348948209100320","article-title":"Tracheoesophageal fistula. 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