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Foreign Body Ingestion in Children: Epidemiological, Clinical Features and Outcome in a Third Level Emergency

Antonio Gatto¹, Lavinia Capossela², Serena Ferretti²

¹Institute of Pediatrics, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Children (Basel, Switzerland)

|December 24, 2021

Insights

Foreign body ingestion is common in children presenting to the Emergency Department (ED). Adhering to guidelines helps prevent unnecessary procedures and delays in pediatric foreign body ingestion cases.

Area of Science:

Pediatric Gastroenterology
Emergency Medicine
Clinical Epidemiology

Background:

Foreign body ingestion is a frequent reason for pediatric emergency department visits.
Understanding epidemiological and clinical features is crucial for effective management.

Purpose of the Study:

To determine epidemiological and clinical features of pediatric foreign body ingestion.
To identify factors associated with urgent invasive procedures or hospitalization.

Main Methods:

Retrospective study of 286 pediatric patients (0-17 years) from October 2014 to June 2019.
Analysis of patient demographics, foreign body type, symptoms, diagnostic tests, treatments, and outcomes.
Evaluation of adherence to ESPGHAN-ESGE guidelines.

Main Results:

Coins were the most common foreign bodies (23%).
Vomiting was the most frequent symptom (7% of symptomatic patients).
Most patients (88.8%) were discharged; 7.3% required hospitalization, with 45% of those undergoing endoscopic procedures.

Conclusions:

ESPGHAN-ESGE guideline application is effective in preventing unnecessary interventions.
Adherence to guidelines avoids diagnostic and therapeutic delays in pediatric foreign body ingestion.

Read full analysis

Abstract:

Ingestion of foreign bodies is a frequent pediatric cause of access to the Emergency Department (ED). The aim of this study was to determine the epidemiological and clinical features of pediatric patients with a diagnosis of foreign body ingestion and to identify the factors associated with an urgent invasive procedure or hospitalization. This is a retrospective study conducted on a population of 286 pediatric patients (0-17 years) evaluated for foreign body ingestion at the Pediatric ED of "Fondazione Policlinico Universitario A. Gemelli, IRCSS" between October 2014 and June 2019. Data concerning age and gender, underlying diseases, type of foreign body, symptoms and signs, instrumental tests, specialist visits, treatment and outcome were analyzed. The majority of foreign bodies were coins (23%). Symptoms recurred in 50% of the foreign bodies with esophageal localization and between the 92 (32%) patients with symptoms the most common was vomiting (7%). X-rays was performed in 61% of patients. Among all patients, 253 patients (88.8%) had been discharged, 21 (7%) had been hospitalized, and four (1.4%) were sent to an outpatient facility. Besides, 17 (5.9%) patients had been transferred to the Observation Unit. Of the hospitalized patients (21 (7.3%)), clinical observation was performed for 57% and endoscopic procedure for 45%. Our data confirm that the ESPGHAN-ESGE guidelines application prevents interventions that are not necessary, avoiding diagnostic and therapeutic delays.

Keywords:

endoscopy foreign bodies ingestion

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