Related Experiment Videos
Ingested foreign bodies in the paediatric patient
G C O'Brien1, D C Winter, W O Kirwan
1Department of Surgery, Cork University Hospital, Cork, Ireland.
Insights
Most pediatric foreign body (FB) ingestions can be managed without intervention. However, guidelines for intervention in children are needed, with symptomatic patients or dangerous objects being key indicators.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Surgical Management
Background:
- Foreign body (FB) ingestion is a frequent occurrence in children.
- While most cases resolve without intervention, a subset necessitates medical or surgical procedures.
Purpose of the Study:
- To develop clear management guidelines for pediatric foreign body ingestion.
- To identify criteria for intervention in pediatric FB ingestion cases.
Main Methods:
- A retrospective chart review was conducted.
- Data from pediatric admissions due to FB ingestion between 1990 and 1999 were analyzed.
Main Results:
- Out of 339 patients, 59 required admission, primarily for large, dangerous FBs, or distant hospital location.
- Endoscopic retrieval was performed in 62.7% of admitted patients, while 5% required surgery.
- 32.2% of admitted patients were discharged without intervention.
Conclusions:
- Conservative management is feasible for most pediatric foreign body ingestions.
- Intervention guidelines for pediatric FB ingestion remain underdeveloped.
- Symptomatic presentation or ingestion of dangerous objects are definitive indications for intervention.
Background:
Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention.
Aims:
To establish clear guidelines for management of paediatric FB ingestion.
Methods:
A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999.
Results:
Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery.
Conclusion:
Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.