Foreign-body ingestion in children: Experience with 1,265 cases

https://doi.org/10.1016/S0022-3468(99)90106-9Get rights and content

Abstract

Bacground/Purpose: This study aims to elucidate the clinical presentation, the effectiveness of investigations, and treatment of foreign body ingestion in children and to formulate an algorithm of management.

Methods: The records of children admitted to a single institution who had a history of foreign body ingestion over 33 years were reviewed. Symptoms, radiological findings, and endoscopic findings were assessed.

Results: Foreign bodies were detected in 552 (43%) of the 1,265 children admitted. The age of the children ranged from 6 months to 16 years (mean, 5.2 years). The preschool toddlers (mean age, 3.8 years) were most prone to ingest inanimate objects. The most common objects were coins (49%) and nonmetallic sharp objects (NMSO; 31%). Although x-rays could detect all the metallic objects and 86% of glass objects, the sensitivity of fish bone detection is only 26%. Absence of symptoms was common (50% in metallic group and 29% in NMSO group). Forty-one percent of coins and 95% of NMSO were lodged at sites suitable for removal by direct laryngoscopy alone with success rates of 86% and 77%, respectively. There were 3 disease-related complications and 1 mortality. Two of these children were mentally retarded and presented late.

Conclusions: Efforts for prevention of ingestion of inanimate foreign body should focus on the preschool toddler group. Particular attention should be paid to mentally retarded children with vague gastrointestinal symptoms. Absence of symptoms does not preclude presence of foreign body in children. Children with history of NMSO ingestion should undergo direct laryngoscopy despite negative radiological finding, both as a screening procedure or treatment.

References (13)

  • HC Emslander et al.

    Efficacy of esophageal bougienage by emergency physicians in pediatric coin ingestion

    Ann Emerg Med

    (1996)
  • RW Byard

    Mechanisms of unexpected death in infants and young children following foreign body ingestion

    J Forensic Sci

    (1996)
  • JG Tucker et al.

    Esophageal perforation caused by coin ingestion

    South Med J

    (1972)
  • K Jiraki

    Aortoesophageal conduit due to a foreign body

    Am J Forensic Med Pathol

    (1996)
  • E Panieri et al.

    The management of ingested foreign bodies in children—A review of 663 cases

    Eur J Emerg Med

    (1995)
  • P Nandi et al.

    Foreign body in the esophagus: Review of 2394 cases

    Br J Surg

    (1978)
There are more references available in the full text version of this article.

Cited by (256)

  • Devices for drug delivery in the gastrointestinal tract: A review of systems physically interacting with the mucosa for enhanced delivery

    2021, Advanced Drug Delivery Reviews
    Citation Excerpt :

    Furthermore, mortality rates among foreign object ingestion is very low. A review of case reports revealed that there were no deaths among 852 adult patients and 1 death among 2206 children [83–86]. In summary, based on prior studies and the size of needles, small capsules with microneedle drug delivery system are likely to be safe though further study will be required for successful translation.

  • Chest CT for the Diagnosis of Pediatric Esophageal Foreign Bodies

    2021, Current Problems in Diagnostic Radiology
View all citing articles on Scopus
View full text