Four Common Esophageal Foreign Bodies in Children
The four most common esophageal foreign bodies in children are coins, toys/toy parts, batteries, and food items (particularly meat and hot dogs). 1
Detailed Breakdown by Frequency
1. Coins
- Coins are the single most common non-food foreign body ingested by children, accounting for approximately 13% of all choking episodes 1
- They represent the most frequently encountered esophageal foreign body in pediatric patients, with one study showing coins comprised 68.8% of pediatric esophageal foreign bodies 2
- Coins typically lodge at anatomical narrowing points: the upper esophageal sphincter (cricopharyngeus muscle) and the thoracic esophagus at the aortic arch level 3, 4
- The cervical esophagus is the most common impaction site in children (78.2% of cases) 2
2. Toys and Toy Parts
- Toys and toy parts represent a major category of esophageal foreign bodies in the pediatric population 1, 5
- Round, ovoid, or cylindrical toy parts pose the greatest risk because they can completely occlude the airway with a snug fit and are difficult to dislodge 1
- Small balls and marbles are particularly dangerous due to their shape and size matching the pediatric airway diameter 1
3. Batteries
- Batteries are a common and particularly dangerous foreign body in children 1, 5
- Button batteries require urgent endoscopic removal even in asymptomatic patients due to high risk of complications including pressure necrosis and perforation 4, 5
- They can cause severe tissue damage within hours of impaction 5
4. Food Items
- Food accounts for 59.5% of all choking episodes requiring emergency treatment in children 1
- Hot dogs are the food most commonly associated with fatal choking and esophageal impaction in children 1
- Other high-risk foods include hard candy (19% of food-related choking), whole grapes, nuts, raw carrots, and meat pieces 1
- In adolescents and adults, meat impaction becomes the predominant food-related foreign body 5, 2
Age-Specific Vulnerability
- Children aged 3 years or younger account for 77.1% of all choking episodes and are at highest risk 1, 3, 4
- The peak age for pediatric esophageal foreign bodies is 2-5 years (34.4% of cases) 2
- This vulnerability stems from incomplete dentition (molars don't erupt until 1.5 years), immature mastication abilities, smaller airway diameter, and the developmental tendency to explore objects orally 1