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Foreign Body Ingestion in Children: A 16-year Experience
Andrea Di Siena1, Paola Melli1, Federica Rodofile1
1Division of Pediatrics, Department of Medicine (DAME), University of Udine, Udine, Italy.
Insights
Foreign body ingestion is common in children, with coins frequently found in the esophagus. Symptoms are associated with upper-middle esophageal foreign bodies, and guideline adherence varies.
Area of Science:
- Pediatric Gastroenterology
- Emergency Medicine
- Endoscopy
Background:
- Foreign body (FB) ingestion is a frequent pediatric emergency.
- Endoscopic removal is necessary for up to 20% of pediatric FB ingestions.
Purpose of the Study:
- To review pediatric FB ingestion cases requiring endoscopy.
- To compare management practices with published guidelines.
Main Methods:
- Retrospective study of children (0-16 years) undergoing endoscopy for FB ingestion (Jan 2007-Dec 2022).
- Analysis of patient demographics, symptoms, FB location, and type.
- Comparison of management against NASPGHAN, ESPGHAN, and SIGENP guidelines.
Main Results:
- 62 children underwent endoscopy for FB ingestion; 62.9% were symptomatic.
- Vomiting, pain, and sialorrhea were the most common symptoms.
- Coins were the most frequent FB (42.0%), predominantly in the esophagus (56.2%).
- Symptomatic presentation correlated with upper-middle esophageal FB location (p<0.001).
- Guideline adherence: NASPGHAN/ESPGHAN (68.8%), SIGENP (72.9%).
Conclusions:
- Coins are the most common foreign bodies ingested by children, often lodging in the esophagus.
- Symptom presence is linked to foreign body location in the upper-middle esophagus.
- Timely endoscopic intervention (within 2 hours) presents challenges.
Purpose:
Foreign body (FB) ingestion is a common health problem that affects children. It requires endoscopic removal in up to 20% of cases. In this study, we reviewed all our pediatric cases of FB ingestion requiring endoscopy and compared their management to the published guidelines.
Methods:
Retrospective study of children (aged 0-16 years) who were admitted to the emergency pediatric service department and underwent endoscopy for FB ingestion from January 2007 to December 2022. All statistical analyses were performed using STATA software version 17.0 (StataCorp LP).
Results:
Of a total of 962 children diagnosed with FB ingestion, 62 of them (median age 4 years; interquartile range 2-8 years) underwent endoscopies and were included in this study. Of these, 39 (62.9%) were symptomatic and 23 (37.1%) were asymptomatic. The most common symptoms were vomiting (24.2%), pain (24.2%), sialorrhea (22.6%). In most patients, FBs were located in the esophagus (56.2%), with coins being the most common type (42.0%). The occurrence of at least one symptom was found to be associated with the FBs located in the upper-middle esophagus (compared to all other anatomical regions) (p<0.001). NASPGHAN and ESPGHAN guidelines were met in 68.8% of patients, while SIGENP guidelines were met in 72.9%.
Conclusion:
FB ingestion is common in children. Coins are the most frequently encountered objects, typically located in the esophagus or stomach. An association was observed between the presence of at least one symptom and FBs located in the upper-middle esophagus. Performing endoscopies within 2 hours of FB ingestion is challenging in some cases.
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