Harm From Foreign Body Ingestion in Adults and Children: A Systematic Review of Case Reports

Intentional and accidental foreign body ingestion is a common presentation seen in emergency medicine, with clinical characteristics and patterns in intentional and accidental foreign body ingestion in adult and paediatric populations being well documented in some foreign body groups, but not others. We conducted a systematic review of case reports and case series from EMBASE, Medline/PubMed, and CINAHL/Ebsco. Of 783 relevant papers, 199 were retrieved after screening, with 120 included in the final analysis. Cases involving magnets and batteries were excluded due to well-documented risks. A wide variety of harms were found, from a relatively small number of foreign body types, notably toothpicks, coins, medication blister packs, and fishbones. Characteristic patterns were found relating to age and type of foreign body ingested, and site of complications. Many injuries occurred distal to the diaphragm, not just above it. Fatal outcomes were described in both intentional and accidental ingestion. We concluded that foreign body ingestion can cause harm in multiple locations throughout the gastrointestinal tract. Clinical patterns vary with patient age and object characteristics. Passage beyond the diaphragm should not provide reassurance, as significant complications may still occur.