Foley catheter extraction for esophageal coin removal in children: The role of sedation
İrem İnanç1
, Sadettin Yıldız1, Mehmet Said Köprülü1, Cansu Erdener Çeliktürk2, Dinçer Avlan3
1Department of Pediatric Surgery, Trakya University Faculty of Medicine, Edirne, Türkiye
2Department of Pediatric Surgery, Edirne Sultan 1. Murat State Hospital, Edirne, Türkiye
3Departments of Pediatric Surgery, Division of Pediatric Urology, Trakya University Faculty of Medicine, Edirne, Türkiye
Keywords: Coin ingestion, esophageal foreign body, Foley catheter, midazolam, pediatric sedation.
Abstract
Objectives: This study aims to evaluate the outcomes of Foley catheter extraction for esophageal coin removal in children and to determine the factors influencing procedural success, with particular focus on the role of sedation.
Patients and methods: Between January 2015 and December 2024, a total of 90 pediatric patients presenting with esophageal coin ingestion were retrospectively reviewed. Following the exclusion of patients who underwent primary endoscopic removal, the remaining 72 patients were evaluated in two groups based on the sedation approach: the sedated group (13 males, 9 females; mean age: 43.1 ± 26.6 months; range, 9 to 108 months) and the non-sedated group (31 males, 19 females; mean age: 48.4 ± 29.4 months; range, 9 to 144 months). Demographic characteristics, coin location, time from ingestion to presentation, extraction method, sedation use, and complications were recorded. Sedation (intravenous midazolam 0.1 mg/kg) was selectively administered when poor cooperation was anticipated. Failure after three attempts prompted endoscopic removal. Sedated and non-sedated groups were compared using chi-square and Fisher's exact tests.
Results: Among the patients who underwent Foley catheter extraction, 22 received sedation, and 50 were managed without sedation. Overall success was 77.8% (56/72). Success was higher in sedated patients (90.9%, 20/22) than in non-sedated patients (72.0%, 36/50), although this difference did not reach statistical significance (odds ratio: 3.89; p = 0.122). Complications were minimal and limited to nasopharyngeal migration (n = 2) and vomiting (n = 2); importantly, all complications occurred in the non-sedated group. No respiratory or sedation-related adverse events occurred. The mean post-procedure observation time was significantly longer in the sedated group (3.1 vs. 2.1 h).
Conclusion: Foley catheter extraction is a safe and effective method for esophageal coin removal in children. Non-sedated extraction was successful in the majority of cases, while sedation may be considered in selected patients where poor cooperation is anticipated.
Citation: İnanç İ, Yıldız S, Köprülü MS, Erdener Çeliktürk C, Avlan D. Foley catheter extraction for esophageal coin removal in children: The role of sedation. Turkish J Ped Surg 2026;40(2):81-86. doi: 10.62114/JTAPS.2026.204.