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Foreign body injuries in children: a review
D Passali1, D Gregori2, G Lorenzoni2
1ENT Clinic University of Siena, Italy;
Insights
Foreign body (FB) injuries are a significant childhood health issue, especially in children aged 0-3. Early diagnosis is crucial as symptoms can be non-specific, leading to delayed treatment and potential complications.
Area of Science:
- Pediatrics
- Public Health
- Emergency Medicine
Background:
- Foreign body (FB) injuries pose a severe public health risk in childhood.
- Children aged 0-3 years are most vulnerable due to oral exploration and inability to discern edible from non-edible items.
Purpose of the Study:
- To provide an overview of current knowledge on pediatric foreign body injuries.
- To focus on FB types, anatomical locations, clinical presentations, and associated complications.
Main Methods:
- Literature review of existing knowledge on pediatric foreign body injuries.
- Analysis of data from the Susy Safe database, including 10,564 cases with available object type information.
Main Results:
- Inorganic objects, such as pearls, balls, and coins, accounted for 74% of identified FBs in the Susy Safe database.
- Symptoms of FB injuries can be non-specific or absent, often leading to misdiagnosis as infections.
- Complications arise based on FB characteristics, anatomical location, child's age, and diagnostic delays.
Conclusions:
- Delayed diagnosis of pediatric foreign body injuries increases the risk of severe complications.
- Understanding FB types, locations, and clinical presentations is vital for timely and accurate diagnosis.
- While many ingested FBs pass naturally, vigilance is required due to potential severe outcomes.
Abstract:
The aim of this paper was to overview existing knowledge on foreign body (FB) injuries in children, with particular focus on FB types and anatomical locations, clinical presentation and complications. FB injuries represent a severe public health problem in childhood. The fact that the highest prevalence of FB injuries is reported for children between 0 and 3 years of age depends primarily on the fact that they explore objects using their mouth and are also not able to distinguish edible objects from non-edible ones. Types of FB causing injuries depend on the symptoms related to FB ingestion/inhalation/insertion (providing an early diagnosis of FB injuries) and complications related to the FB characteristics (type, shape, dimensions). The analysis of the Susy Safe database showed that in 10,564 cases, in which the object type was available, 74% of objects were inorganic and were mostly represented by pearls and balls, followed by coins. The main concerning about FB injuries is the fact that they may be asymptomatic or that symptoms may be non-specific. Consequently, the FB injury can be misinterpreted as a gastrointestinal or respiratory infection. The absence of specific symptoms indicating the occurrence of FB injury can lead to delays in diagnosis, thereby increasing the risk of complications. Symptoms seem to mostly depend on the anatomical location. Many ingested FBs pass naturally through the gastrointestinal tract without complications or damage. However, severe complications can occur depending on the characteristics of the FB, its anatomical location, the child's age and delays in diagnosis.
