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Foreign Body Ingestion in Pediatrics: Distribution, Management and Complications
Jiraporn Khorana1,2, Yaowaret Tantivit3, Chanitsara Phiuphong4
1Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, 110 Intavaroros Road, Muang Chiang Mai District, Chiang Mai 50200, Thailand. nanji22@gmail.com.
Insights
Foreign body ingestion in children is common, with coins frequently found in the esophagus. New Chiang Mai University (CMU) Guidelines are recommended for managing these cases.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Public Health
Background:
- Foreign body (FB) ingestion is a frequent pediatric emergency.
- It can lead to severe complications in children.
- Effective management guidelines are crucial.
Purpose of the Study:
- To determine the types and locations of ingested foreign bodies in children.
- To develop evidence-based Chiang Mai University (CMU) Guidelines for FB ingestion management.
- To analyze the outcomes of different management strategies.
Main Methods:
- Retrospective descriptive study of pediatric patients (<15 years) with FB ingestion (ICD-10 codes T18).
- Data collected from January 2006 to December 2017 at CMU Hospital.
- Descriptive statistics used for data analysis.
Main Results:
- 194 FB ingestion episodes analyzed; median age 43.5 months.
- Coins were the most common FB (41.2%), predominantly in the esophagus (37%).
- Vomiting was the most frequent symptom; 9.3% experienced pre-treatment complications.
Conclusions:
- Foreign body ingestion is prevalent in children under four.
- Coins are the most common foreign body, with the esophagus being the most frequent location.
- The developed CMU Guidelines are recommended for clinical management.
Abstract:
Background and Objectives: Foreign body (FB) ingestion is a common problem in children, causing serious complications. This study aimed to identify the distribution of types and locations of these foreign bodies and create Chiang Mai University (CMU) Guidelines. Materials and Methods: A retrospective descriptive study was conducted. All patients under 15 years old with foreign body ingestion (International Statistical Classification of Diseases and Related Health Problems; ICD-10 codes T18) treated in CMU Hospital from January 2006 to December 2017 were included. The data were analyzed using descriptive statistics. The guidelines were created, which paralleled the standard guidelines. Results: In total, 194 episodes of FB ingestion were recorded. These included 53.6% males and 46.4% females with a median age of 43.5 months. A history of foreign body ingestion complaints occurred in 77.8% of cases. Presentation was divided into asymptomatic (44.3%) and symptomatic (55.7%). The most common symptom was vomiting (23.2%). In the majority of cases, foreign bodies were located in the esophagus (37%). The most common type of foreign body was a coin (41.2%). Management included spontaneous passing (60.3%), endoscopy (35.6%), and others (3.1%). Complications before treatment were recorded in 9.3% of cases and after treatment in 2.1% of cases. Conclusions: Foreign body ingestion is common among children younger than four years old. Coins are the most common foreign body found, and the esophagus is the most common location. We recommend our created CMU Guidelines for management.
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