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. 2019 Oct 14;55(10):686.
doi: 10.3390/medicina55100686.

Foreign Body Ingestion in Pediatrics: Distribution, Management and Complications

Jiraporn Khorana  1   2 , Yaowaret Tantivit  3 , Chanitsara Phiuphong  4 , Saranchana Pattapong  5 , Suparat Siripan  6
Affiliations

Foreign Body Ingestion in Pediatrics: Distribution, Management and Complications

Jiraporn Khorana et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Foreign body (FB) ingestion is a common problem in children, causing serious complications. This study aimed to identify the distribution of types and locations of these foreign bodies and create Chiang Mai University (CMU) Guidelines. Materials and Methods: A retrospective descriptive study was conducted. All patients under 15 years old with foreign body ingestion (International Statistical Classification of Diseases and Related Health Problems; ICD-10 codes T18) treated in CMU Hospital from January 2006 to December 2017 were included. The data were analyzed using descriptive statistics. The guidelines were created, which paralleled the standard guidelines. Results: In total, 194 episodes of FB ingestion were recorded. These included 53.6% males and 46.4% females with a median age of 43.5 months. A history of foreign body ingestion complaints occurred in 77.8% of cases. Presentation was divided into asymptomatic (44.3%) and symptomatic (55.7%). The most common symptom was vomiting (23.2%). In the majority of cases, foreign bodies were located in the esophagus (37%). The most common type of foreign body was a coin (41.2%). Management included spontaneous passing (60.3%), endoscopy (35.6%), and others (3.1%). Complications before treatment were recorded in 9.3% of cases and after treatment in 2.1% of cases. Conclusions: Foreign body ingestion is common among children younger than four years old. Coins are the most common foreign body found, and the esophagus is the most common location. We recommend our created CMU Guidelines for management.

Keywords: endoscopy; foreign body ingestion; guidelines; pediatric.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram showing distribution of ingested foreign bodies and result of management.
Figure 2
Figure 2
Management algorithm for foreign body ingestion. A = airway; B = breathing; C = circulation.
Figure 3
Figure 3
Management algorithm for foreign bodies in esophagus. BB = button battery; TE = tracheoesophageal malformation; # Symptomatic = cannot manage secretion, sore throat; * Emergent = within 2 h; Urgent = within 24 h; Elective = more than 24 h.
Figure 4
Figure 4
Management algorithm for foreign bodies in stomach and duodenum. BB = button battery.
Figure 5
Figure 5
Management algorithm for foreign bodies beyond the duodenum. BB = button battery. IPD = inpatient department. * Symptomatic; peritonitis, bowel obstruction.
See this image and copyright information in PMC

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