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Foreign Body Ingestion and Management in Children
Hakan Salman1, Tuğba Gürsoy Koca2, Selim Dereci3
1From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Suleyman Demirel University Faculty of Medicine, Isparta.
Insights
Most children with foreign body (FB) ingestion experience spontaneous resolution. However, prompt endoscopic intervention is crucial for a significant number of cases, especially when underlying esophageal conditions are present.
Area of Science:
- Pediatric Gastroenterology
- Endoscopic Procedures
- Medical Case Reviews
Background:
- Foreign body (FB) ingestion is a common pediatric emergency.
- Prompt diagnosis and management are essential to prevent complications.
Purpose of the Study:
- To evaluate the characteristics and treatment outcomes of children with foreign body ingestion.
- To identify risk factors and optimal management strategies for pediatric FB ingestion.
Main Methods:
- Retrospective analysis of 297 children treated for FB ingestion between January 2014 and August 2021.
- Data collected included patient demographics, type of FB, presenting symptoms, diagnostic methods, and treatment outcomes.
Main Results:
- Coins were the most frequent ingested FB (29.6%), with vomiting as the most common symptom (15.8%).
- Endoscopic removal was performed in 25.3% of cases, with coins being the most commonly removed FB.
- Spontaneous expulsion occurred in 71% of cases, while 7 cases involved food bolus impaction with associated esophageal pathologies.
Conclusions:
- While most foreign body ingestions resolve spontaneously, a notable proportion requires timely endoscopic intervention.
- Underlying esophageal conditions must be considered in cases of food bolus impaction to guide management and prevent serious outcomes.
Objective:
The aim of the study is to evaluate of the children who came to our hospital with the complaint of foreign body (FB) ingestion and were treated.
Methods:
A retrospective evaluation was made of the records of children who presented at our institution between January 2014 and August 2021 with the complaint of FB ingestion.
Results:
Evaluation was made of 297 children, comprising 121 female children (40.7%) with a mean age of 61.1 ± 50.3 months (range, 4-202 months). The ingested FB most frequently was coins (n = 88, 29.6%). The most common complaint on presentation was vomiting in 47 cases (15.8%). Endoscopy was applied to 75 cases (25.3%), and most common FB was removed from the upper esophagus in 31 cases (41.3%). The most frequently removed FB was coins at the rate of 40%. Of the 211 cases left to a spontaneous course, 117 were in the intestines, 22 in the stomach, and in 72 cases localization could not be determined on conventional radiography as the FB was not opaque. In 7 cases with a bolus of food caught in the esophagus, 3 had corrosive esophagus stricture (1 case with colon transposition), 2 had operated esophagus atresia, 1 had eosinophilic esophagitis, and 1 had congenital esophagus stricture.
Conclusions:
Although there can be serious outcomes, there is spontaneous expulsion in most cases. However, a significant proportion requires a timely endoscopic procedure. Attention must be paid to underlying diseases when FBs, such as a food bolus, are in the esophagus.
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