International Journal of Pediatrics 3 Table 2: Comparison among characteristics recorded in the present case series and in 4 published case series. Data are given as percentage. First author, publication year, country, number of retrieved FB Buenos Aires 2009, Argentina, 320 FB Gregori et al. 2010, [7] Europe, 186 FB Little et al. 2006, [9], USA, 555 FB Lin et al. 2007, [8], Taiwan, 38 FB Van As et al. 2003, [10], South Africa, 735 FB Distribution by sex Distribution by age Males Females Mean age FB type Organic FB Inorganic FB Adult present Yes No Location: Esophagus Upper Middle Distal Most frequent symptom Most frequent complication 50.94 49.06 4.58 4.7 93.3 85.3 14.7 8.4 84.1 7.5 61 49 2 19.9 80.1 89.8 10.2 53.7 46.3 3.24 12 88 73 14 12 58.1 41.9 4 5.3 94.7 26 5 7 No available data. 3 years incidence peak (24) 49 51 8 92 Vomiting (28.7) Esophageal perforation (0.31) Dysphagia (23) Dysphagia (37) Odynophagia (84) Pneumonia (1.08) Epistaxis (0.36) Erosive esophagitis (2.6) No complications pieces and buttons [7–9, 14]. Unlike Asian literature [13, 15], bones were not found with a high frequency. Objects’ characteristics such as shape, dimension, and consistency are important in order to determine the damage that might occur. Rimell and Stool [16] performed a retro- spective study in which they examined the characteristics of objects that had caused serious aerodigestive tract (airway, cricopharyngeal, or esophageal) injuries, with the deﬁnition of serious being indicated by the need of operative removal or the occurrence of death due to choking, as reported from the Consumer Product Safety Commission (CPSC). Their results conﬁrmed previous reports found in the medical literature, showing that the risk of injury or death posed by food, toy or toy part, or another object depends upon its size, shape, and consistency [17, 18]. The majority of swallowed foreign bodies pass harmlessly and spontaneously through the gastrointestinal tract (GIT) [8], but in case of lodgement or toxicity of the object, the FBs must be rapidly identiﬁed and removed. The most frequent lodgement site described in literature is the cricopharyngeus muscle [19, 20], while in our study the middle part of the esophagus was most frequent. Sharp items can lodge anywhere, and patients who have esophageal abnormalities such as tracheoesophageal ﬁstulas are at risk of entrapment in atypical locations. Although most objects pass easily through the intestine, entrapment can occur at the pylorus, at the ligament of Treitz, and at the ileocecal valve [21]. Ingestions can vary in presentation from an asymp- tomatic state to respiratory distress or acute abdomen. Esophageal objects can cause a foreign body sensation, drooling, or respiratory distress due to tracheal compression, gagging, dysphonia, vomiting, and dysphagia, depending on the location and the nature of the FB [22]. Although a high percentage of children presented symptoms as vomiting and odynophagia, there were also a large percentage of asymp- tomaticcases. The delayed onset of symptoms is associated with an increased risk of complications: when presentation occurs after more than 24 hours, with the FB producing local inﬂammation in the mean time, it can potentially result in obstruction and mucosal and muscular erosion causing emesis, abdominal distension, or gastrointestinal bleeding. When the episode of the ingestion remains undetected, symptoms of chronic illness can develop, including signs as fever and weight loss. Although rare, perforating objects are potentially life threatening because they may provoke the formation of a ﬁstula between the esophagus and the innominate artery thus ensuing catastrophic bleeding [23, 24]. Other complications associated with retained esophageal foreign bodies are tracheal compression and erosion through the mucosa, with FBs migration into adjacent structures, such as the respiratory tract or the aorta. For all the gastrointestinal foreign bodies, the type of object, its location, and child’s symptoms dictate treatment. In 2005, Waltzman et al. performed a randomized trial in children with coins lodged in the esophagus after their inges- tion, comparing relatively immediate endoscopic removal to the choice of observation for a deﬁnite period of time [25] and retrieved a high frequency of spontaneous passages