Author(s)
Lauren Himes, MD
Daniel Kirse, MD
Jacline Phillips, MD
Samuel Kirse
Eleanor Kiell, MD, MSEd
Affiliation(s)
Wake Forest University School of Medicine;
Abstract:
Introduction: Pediatric esophageal foreign bodies are a common problem encountered by otolaryngologists and can be managed with operative interventions, including flexible or rigid endoscopy, or non-operative interventions. Ingestion of solid foods has been anecdotally mentioned as means for management for esophageal foreign bodies but has not been formally studied in the literature. We present the first case series of pediatric patients with esophageal foreign bodies managed with administration of peanut butter.
Methods:
This is a retrospective case series of 16 patients less than 18 years old who presented to a tertiary care center pediatric emergency department with esophageal foreign body ingestion from January 2012 Through August 2023 who were administered peanut butter for primary treatment. A comprehensive database was built from the electronic medical record including demographic information and details of clinical management.
Results:
All 16 patients were administered peanut butter for primary treatment of esophageal foreign bodies. 15 of 16 patients had coins as the foreign body. 12 out of 16 patients had passage of the esophageal foreign body into the stomach within two hours and did not require operative intervention for removal. Fourteen patients had foreign body below the level of the aortic arch and peanut butter was successful in 11 of these patients. Two patients had foreign body above the aortic arch and one failed treatment with peanut butter. Interestingly, three of the four patients who failed peanut butter treatment had a quarter as their foreign body. No complications were observed in any patient who was administered peanut butter regardless of the outcome of the treatment.
Conclusions:
We have seen that peanut butter administration has been successfully and safely used for primary treatment of select esophageal foreign bodies. The overall rate of passage of esophageal foreign bodies treated with peanut butter in this case series was 75% and is likely much higher when the foreign body is a penny. Because of these promising results, we have assembled a multi-disciplinary team to construct a clinical care pathway to include peanut butter as primary treatment for select patients with esophageal foreign bodies that will be presented.