Foreign bodies in children: a comparison between Argentina and Europe

Foreign bodies (FB) aspiration, ingestion, insertion or inhalation can be a serious occurrence, resulting in fatality if not promptly recognized and solved. The aim of the current paper is to present foreign body ingestion's cases observed at the Children's Hospital Gutierrez in Buenos Aires in 5 years of ORL activity and to compare main findings with data coming from other well known already published case series.

A prospective study was realized on children having ingested, inhaled, aspirated or introduced FBs, with regard to age and sex distribution, FB's type, dimensions and consistency, FB's location, clinical presentation, removal and occurrence of complications.

FBs retrieved amounted to 2336 cases. The most common location was the nose (66.7%), where the most frequent FBs retrieved were inorganic (72.7%) and occurred in children younger than 3 years old (54.2%), the only position where children younger than 3 years are a majority in respect to the older ones. The presence of the adult was seen in the preponderance of cases (88.4%). Symptoms varied between the different anatomical systems, with cough as predominant when concerning aspiration, local pain or inflammation in inhalation and insertion, and vomiting in for the FBs ingestion cases. All the foreign bodies retrieved were clustered in categories, due to necessity when extremely various and with low absolute frequency. The most common FBs retrieved were pearls (20.2%), followed by stationery products (mostly rubbers) and coins. Complications had a low rate in all the studies.

The study stresses the importance of primary prevention, seen as the active care of adults toward children manipulating foreign bodies potentially dangerous. This presence may not avoid the event, but in case of FBs aspiration, ingestion, insertion or inhalation, it could be the main factor leading to a faster and correct treatment. Prompt removal of the foreign body decreases the risk of complications, resulting in a lower length of hospitalization. Symptoms were various and differed in all the studies, showing that their wide amount indicates the importance of registries to early recognize and therefore treat a pathology that might be mistaken for something different due to unspecific signs. Secondary prevention with specific training of doctors on clinical post-trauma guidelines for treatment and active participation of doctors to the broadening of the current registries seem to be other ways for lowering the outburst of FBs injuries.