Analysis of risk factors associated with surgical treatment for children with foreign body ingestion

Foreign body ingestion (FBI) is a common pediatric emergency that can lead to significant morbidity. The clinical outcome is significantly influenced by the type, size, and location of the object, as well as how long it has been inside the body for. This study aims to summarize the clinical characteristics of FBI in the digestive tracts of children and analyze the diagnosis, treatment, and risk factors for surgical intervention of digestive tract foreign bodies.

This retrospective cross-sectional study included all pediatric patients (aged 0-18 years) diagnosed with digestive tract foreign bodies at the Qilu Hospital of Shandong University Dezhou hospital from December 2021 to December 2025. The data included demographic information, clinical manifestations, type, quantity, and location of the FBI, time of ingestion, treatment methods, and complications. The collected data were statistically analyzed using descriptive statistics, chi-square tests, and logistic regression analysis to identify the risk factors for surgical intervention for FBI.

A total of 194 children were included in this study. Among them, 71 cases had foreign bodies removed through endoscopy or surgery, while 123 expelled the foreign bodies spontaneously. The male to female ratio was 127:67. The number of children under 3 years old was the largest, with a total of 106 cases (54.64%). Retention time of FBI for less than 24 h occurred in 153 cases (78.87%), 84 cases (43.30%) had symptoms, and FBI being mostly located in the upper digestive tract accounted for 140 cases (72.16%). The foreign bodies were mostly coins and plastics, with 53 cases (27.32%) and 31 cases (15.98%), respectively. There were 76 cases (39.18%) of sharp or corrosive FBI. Foreign body quantity was less than 2 in 168 cases (86.60%), and 32 cases (16.49%) had injuries in the digestive system or other systems. This study divided the 71 cases that had the foreign bodies removed through endoscopy or surgery into the surgical treatment group (11 cases) and the endoscopic treatment group (60 cases). It was found that factors such as age, foreign body type, foreign body quantity, retention time of FBI, the hospitalization time, and bodily injury were significantly related to whether surgical treatment was performed (P < 0.05).

Surgical treatment is a method for addressing FBI. Age, foreign body type, foreign bodies quantity, retention time of FBI, and digestive system or other system injury are all risk factors for surgical treatment. This study systematically summarizes the indications and methods of surgical treatment for FBI to provide a reference for clinical decision-making.