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Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
Published on: September 11, 2018
[Consultations for digestive foreign bodies ingestion in a pediatric emergency department.]
Celia Martí-Castellote1, Aitor López-González1, Victoria Trenchs Sainz de la Maza1,2,3
1Servicio de Urgencias de Pediatría. Hospital Sant Joan de Déu. Esplugues de Llobregat. Barcelona. España.
Insights
Foreign body (FB) ingestion is common in children, with most cases involving accidental swallowing of metallic objects. While many children are discharged, some require further tests or endoscopy.
Area of Science:
- Pediatrics
- Emergency Medicine
- Toxicology
Background:
- Foreign body (FB) ingestion is a frequent cause of pediatric emergency department visits.
- Accidental ingestion poses risks and necessitates prompt medical evaluation.
Purpose of the Study:
- To determine the epidemiological characteristics of children presenting with suspected foreign body ingestion.
- To analyze the consequences and management of foreign body ingestion in pediatric patients.
Main Methods:
- A descriptive-observational study was conducted at a tertiary maternal and child center.
- Emergency reports of patients under 18 with foreign body ingestion diagnoses were analyzed (2017-2018).
- Data included patient demographics, object type, symptoms, diagnostic tests, and outcomes.
Main Results:
- 458 cases were analyzed; the median age was 3.8 years, with 58.3% males.
- Metallic objects (46.7%) were the most common, often ingested accidentally by preschoolers.
- Nearly 70% underwent diagnostic tests, 9.6% required endoscopy, and 12.1% were re-evaluated.
Conclusions:
- Foreign body ingestion is a common pediatric emergency, frequently involving metallic objects.
- Most cases are managed in the emergency department, but diagnostic workup and interventions like endoscopy are sometimes necessary.
- The typical patient is a preschooler with accidental ingestion of a blunt metallic foreign body.
Objective:
Foreign body (FB) ingestion distresses many families who consult the emergency department promptly. The objective of the study is to determine the epidemiological characteristics of children who consult due to suspected FB intake and its consequences.
Methods:
Descriptive-observational study, carried out in a third-level maternal and child center. Emergency reports were selected from patients under 18 years of age with a diagnosis of discharge "Ingesta CE" (code 938 CIM-9-MC until May 2018; code T18.9XXA CIM-10-MC later) from 1/1/2017 until 12/31/2018. Miscoded and reconsultations within the same episode were excluded. Data was analysed with the statistics program SPSS 25.0.
Results:
458 cases were included; median age 3.8 years (p25-75: 1.9-6.6 years); 267 (58.3%) males. 78.9% consulted in the first 6 hours after intake. Accidental cause was reported in 98.9% of cases. In 96.7% a single FB was ingested. The most frequent types of object were metallic (46.7%), plastics (16.4%) and food bones/shells (12.9%). The 23.6% of FB involved were sharp/pointed. 49.1% of the patients presented symptoms. A complementary test was performed in 69.4%, especially radiographs (63.5%). Metal detector was used in 10%. 9.6% required endoscopy. 90.4% were discharged from the emergency department, with 12.1% of reconsultations.
Conclusions:
Consultations for FB ingestion are relatively frequent in the emergency department and, although most of them are discharged, many patients require complementary tests and a non-negligible number, endoscopy. The patient's profile is that of a preschooler who spontaneously goes to the emergency room due to an accidental ingestion of a blunt metallic object.
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