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Foreign Body Ingestion in Children: An Experience of 99 Cases in a Tertiary Care Center in Delhi
Meghna Kinjalk1, Mehak Sehgal1, Simmi K Ratan1
1Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
Insights
Pediatric foreign body ingestion is common, with coins being the most frequent culprit. Most ingested foreign bodies crossing the duodenojejunal flexure are managed conservatively, while upper GI foreign bodies are often removed endoscopically.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Emergency Medicine
Background:
- Accidental foreign body ingestion in children presents critical challenges due to communication barriers.
- Understanding the epidemiology and management of foreign body ingestion is vital for pediatric care.
Purpose of the Study:
- To determine the epidemiology of foreign body ingestion in children under 12.
- To analyze variations in ingestion based on age, gender, foreign body type, and location.
- To describe the management strategies employed for pediatric foreign body ingestion.
Main Methods:
- Retrospective study of 99 children under 12 years with confirmed foreign body ingestion (January 2020 - June 2022).
- Clinical and radiological assessment followed by observation or emergent management (endoscopy/surgery).
- Comparative analysis of management based on patient demographics and foreign body characteristics.
Main Results:
- Coins were the most frequent foreign body ingested across all age groups.
- 74.7% of foreign bodies distal to the duodenojejunal flexure were managed conservatively.
- Endoscopic removal was performed in 21 cases, and surgical intervention in three cases.
Conclusions:
- Coins are the most common gastrointestinal foreign bodies in children.
- Button batteries require careful management based on location; upper GI foreign bodies are often endoscopically removable.
- Parental education is crucial for preventing foreign body ingestion in children.
Background:
Accidental ingestion of foreign bodies in children is critical, as the inability to effectively communicate can potentially lead to devastating consequences. We aimed to determine the epidemiology of foreign body ingestion and variability according to age, gender, type, and location of foreign body, and describe its management.
Aim And Objective:
The aim was to study the various types of foreign body ingestions in children admitted to pediatric surgery and their management.
Materials And Methods:
A retrospective study was conducted from January 2020 to June 2022 on children under the age of 12 years with a confirmed diagnosis of foreign body ingestion. Patients were clinically and radiologically assessed, after which standard protocols were followed wherein patients were followed by either observation or emergent management. Emergent management included removal of the foreign body by either endoscopy or surgery. Comparisons among multiple age groups, gender, type of foreign body, location of foreign body, and their management were analyzed.
Results:
Out of 99 subjects in our study, there were 76 boys and 23 girls. The median age of presentation was 5 years. Most children were asymptomatic at presentation. The most frequently ingested foreign body was a coin in all age groups. The majority of the foreign bodies were suspected to be in the small bowel. The foreign bodies that had crossed the duodenojejunal flexure (n = 74, 74.7%) were managed conservatively with the observation of a variable period of a minimum of 24 h and a maximum of 48 h. 21 cases were managed by endoscopic removal, while three cases required surgical intervention.
Conclusions:
Overall, the most common gastrointestinal foreign body was a coin in all age groups. Button battery is the most worrisome foreign body; however, depending on its position, it can be managed conservatively. Upper GI foreign bodies can be safely removed endoscopically. Parental counseling is very important for the prevention of ingestion of foreign bodies.
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