Global insights on the diagnosis, management, and prevention of pediatric ingestions: A report from the FISPGHAN expert panel

Abstract

This is a comprehensive review of pediatric foreign body (FB) ingestions, emphasizing the global burden, epidemiology, and management strategies. Predominantly occurring in children under 6, with a peak between 6 months and 3 years, these incidents pose significant health risks with substantial regional variations in ingested objects-ranging from household items to caustic substances. The pathophysiological effects of ingestions are outlined, highlighting specific dangers associated with button batteries, sharp objects, and caustic agents, which can lead to severe tissue damage and long-term complications. A survey of (70) pediatric gastroenterologists from FISPGHAN societies revealed varied regional practices in the frequency of different FB ingestions with food impaction highest in North America and Ocenaia and caustic ingestion more common is Asia. Button batterers were serious concerns across all regions. Management approaches, specifically intubation practice varied across regions. A review of management protocols for different types of ingestions are provided, emphasizing the urgency of endoscopic removal and follow-up care. Prevention strategies are critical, with a focus on public health interventions, legislation, and education to mitigate the risks associated with FB and caustic ingestions. This report underscores the need for enhanced preventive measures and uniform management guidelines to reduce the incidence and improve outcomes of pediatric ingestions worldwide.

Keywords: button battery; caustic; foreign body removal; magnet ingestion; water beads.

Figure 1

Geographic location of survey respondents.

Figure 2

Reported frequency of pediatric ingestions by type across geographic regions.

Figure 3

Regional variation in (A) intentional ingestions, and (B) delayed presentations of pediatric ingestions.

Figure 4

(A) Anteroposterior film of button battery's double rim or halo sign. (B) Lateral chest film button battery step‐off sign. This sign indicates the difference in size between the two metallic disks that make up the battery.