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Foreign body ingestion in children: an audit of transit time
1Royal Aberdeen Children's Hospital.
Insights
Transit time for ingested radio-opaque foreign bodies in children is highly variable and unpredictable. Stool examination is unhelpful, and repeat radiography is discouraged due to radiation exposure.
Area of Science:
- Pediatric Gastroenterology
- Radiology
- Emergency Medicine
Background:
- Ingestion of radio-opaque foreign bodies is common in children.
- Management strategies often rely on predicting foreign body transit time.
Purpose of the Study:
- To investigate the patterns of radio-opaque foreign body ingestion in children.
- To determine the average rectal passage time for these objects.
- To inform and rationalize future management protocols.
Main Methods:
- A prospective study involved 100 children under 14 years old.
- Participants presented to the emergency department after ingesting a radio-opaque foreign body.
- Initial radiography and follow-up were used to track transit time.
Main Results:
- Most ingestions (73%) occurred in children aged 5 years and under.
- Rectal passage time varied significantly, with nearly half of foreign bodies not recovered.
- Transit time appeared to increase with age.
- Cisapride was administered to three children for prolonged gastric retention.
Conclusions:
- Foreign body transit time in children is unpredictable.
- Routine stool examination is not beneficial.
- Repeat radiography should be avoided to minimize radiation exposure.
- Cisapride may aid in cases of prolonged gastric retention, warranting further investigation for routine use.
Objectives:
To study the pattern of ingestion of radio-opaque foreign bodies in children and to ascertain the average transit time to passage per rectum in order to rationalise future management.
Methods:
This prospective study consisted of 100 children under the age of 14 years, presenting to the accident and emergency department of the Royal Aberdeen Children's Hospital having ingested a radio-opaque foreign body. All children had initial radiography and were subsequently followed up in an attempt to ascertain the transit time of the foreign body.
Results:
The majority of ingestions (73%) were in younger children (5 years and under). The time taken to pass the foreign bodies per rectum varied greatly. Almost half were never recovered. Transit time appears to increase with age. Three children were given oral cisapride to increase gastric motility after prolonged retention in the stomach.
Conclusions:
Transit time is very variable and cannot be predicted. Sifting of the stools is unpleasant and unhelpful. Repeat radiography should not be encouraged as this results in unnecessary radiation. Cisapride may be useful in cases where there is prolonged retention of a foreign body in the stomach. There may be an indication for routine use of cisapride in all cases of ingested foreign bodies, however further audit would be required.
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