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Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
Published on: September 11, 2018
High-Risk foreign body ingestion in children: clinical features and endoscopic outcomes
Ning Xue1, Xuxia Wei1, Junjie Xu1
1Department of Gastroenterology, Children's Hospital Affiliated to Shandong University (Jinan Children's Hospital), Jinan, Shandong, China.
Insights
High-risk foreign body ingestion in children, particularly multiple magnets, poses significant dangers with high perforation and surgery rates. Endoscopic retrieval is effective, but urgent intervention is crucial for magnets and delayed cases.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Endoscopy
- Foreign Body Ingestion
Background:
- Upper gastrointestinal (GI) foreign bodies in children present a significant clinical challenge.
- Stratification by object type is crucial for understanding varied clinical presentations and outcomes.
Purpose of the Study:
- To evaluate clinical features and endoscopic outcomes in children with high-risk upper GI foreign bodies.
- To stratify these outcomes based on the type of foreign body ingested: sharp objects, magnetic objects, or button batteries.
Main Methods:
- A retrospective review of 155 pediatric cases with upper GI foreign body retention was conducted.
- Patients were categorized by foreign body type (sharp, magnetic, button battery), and data on demographics, symptoms, retention, injuries, complications, and outcomes were analyzed.
Main Results:
- Sharp objects, magnets, and button batteries showed significant differences in age distribution, retention sites, and duration of ingestion.
- Magnetic foreign bodies, especially multiple magnets, were associated with the highest rates of vomiting, perforation, and surgical intervention.
- Esophagogastroduodenoscopy (EGD) demonstrated a high success rate (96.1%) as a first-line treatment.
Conclusions:
- Ingestion of high-risk foreign bodies, particularly multiple magnets, requires urgent intervention due to associated high morbidity.
- EGD is an effective first-line endoscopic therapy for upper GI foreign bodies in children.
- Risk-stratified management and post-removal follow-up are essential for optimizing patient outcomes.
Objective:
To evaluate clinical features and endoscopic outcomes in children with high-risk upper gastrointestinal (GI) foreign bodies, stratified by object type.
Methods:
We retrospectively reviewed cases of children who ingested high-risk foreign bodies with upper GI retention at a Chinese tertiary pediatric center (January 2020-December 2024). Patients were stratified by the type of ingested foreign body: sharp objects, magnetic objects, or button batteries. Demographics, symptoms, retention sites, injuries, complications, and outcomes were analyzed.
Results:
Among 155 children, 61 (39.4%) ingested sharp objects, 42 (27.1%) magnetic objects, and 52 (33.5%) button batteries. All underwent attempted endoscopic retrieval. Groups differed significantly in age, retention site, and ingestion-to-presentation duration (all P < 0.05). Button battery ingestions occurred predominantly in children aged 0-3 years; sharp objects predominantly lodged in the esophagus, while magnets and button batteries were mainly retained in the stomach. Magnetic ingestions had the longest duration (>24 h) because they were often asymptomatic. Pain was more common with sharp and magnetic objects (P < 0.05); vomiting and perforation rates were highest in the magnetic group (P < 0.05), likely because only cases involving ≥2 magnets were included. Dysphagia was more frequent with sharp objects and batteries (P < 0.05). Esophagogastroduodenoscopy (EGD) was first-line with a success rate of 96.1%; two sharp cases needed rigid esophagoscopy, and the magnetic group had higher surgical rates (P < 0.05).
Conclusion:
High-risk foreign body ingestion is dangerous, especially ingestion of multiple magnetic foreign bodies, which are associated with high perforation and surgical rates. EGD is effective first-line therapy. Urgent intervention is needed for multiple magnets (even asymptomatic) and delayed cases. Post-removal follow-up is important, and our comparative analysis guides risk-stratified management.
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