Abstract
FOREIGN BODY INGESTION AMONG CHILDREN: DIAGNOSIS, TREATMENT AND COMPLICATIONS

Khaled Al Attrash, Amal Naous*, Ziad Naja, Georges Habr, David Breich and Mariam Rajab

ABSTRACT

Background: Foreign-body ingestion is a gastrointestinal emergency, often requiring presentation to an emergency department for urgent evaluation and treatment. Methods: A retrospective chart review of children between 6 months and 14 years of age who presented to Makassed General Hospital for suspected foreign body ingestion. Demographic data collected from medical chart included age, gender, type and location of foreign body, management, associated upper gastrointestinal disease, and outcome (complications, success rate and mortalities). Results: Over a 10-year period, a total of 403 patients presented to our hospital for suspected foreign body ingestion. The mean age of children was 5.4 (±1.8) years (range: 6 months-14 years). There was a slight male predominance (male/female ratio was 1:1.16). The most common presenting symptom was foreign body sensation and pain (31%) in children >5 years. The duration of symptoms was longer in patients presented with history of food impaction (median 33.9 h vs. 8 h) (P < 0.0001). Physical examination did not reveal any abnormality in most patients. The most common localization of the foreign bodies shown in plain X-ray was in the esophagus (33.9%). X-ray was normal in 6.3% of the patients. The age of patient did not determine the localization of FB on admission (P = 0.436). Endoscopic removal was attempted in 46.1% and was successful in 96.4% of patients in which the most common (47.1%) of retained foreign bodies was coins. The majority of foreign bodies were located in the upper esophagus (62%). Management of foreign bodies differs according to the localization, type of foreign bodies and the severity of symptoms in children. The duration of hospitalization was longer in patients with delayed admission (P value < 0.0001). Conclusion: Foreign bodies’ ingestion in children suggests that, selectively, most children can be observed at home and the decision between endoscopic intervention and observation on an outpatient basis depend on the type, location and duration of the ingested foreign bodies. It is a main responsibility of the parent to minimize exposure to potentially harmful agents and the pediatric physicians to provide education to families regarding the types of household objects that carry potential risk to children.

Keywords: Foreign body, Endoscope, Emergency Department.


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