Management of pediatric patients who have swallowed foreign objects

The clinical management of children who have swallowed foreign bodies presents a great challenge for both pediatricians and pediatric surgeons. Our 7-year experience of treating 141 patients with a history of foreign body ingestion is reported. In 114 patients, there were 122 foreign bodies present in areas from the esophagus to the rectum, as located by plain chest and abdominal x-ray examination. In two patients, a plastic toy and the plastic cap of a razor were passed with stool a few days later. In the remaining 25 patients, nothing was found. In babies under one year of age, button batteries were the most commonly swallowed foreign bodies, while coins were the most frequently swallowed objects in children over the age of three years. Seventeen foreign bodies in the esophagus were removed: seven by balloon catheter, four endoscopically, and one by a magnet tube. Four were dislodged into the stomach. Twenty nine of the 78 items present in the stomach were button batteries and 23 of the items were removed using a magnet tube. One was removed endoscopically and 5 batteries that had moved beyond the pylorus were excreted within 48 hours. Twenty four coins in the stomach were managed conservatively. Surgical intervention was required in two patients; one patient had a previous history of pyloromyotomy, and a magnet tag measuring 1.5 cm in diameter did not pass through the pylorus for 7 weeks. The other patient had swallowed a sewing needle that moved into the descending colon and abdominal pain ensued.