Foreign Bodies Ingestion in Children: Experience of 61 Cases in a Pediatric Gastroenterology Unit from Romania

Abstract

The ingestion of foreign bodies is a worldwide pediatric pathology. We assessed the clinical, endoscopic, and therapeutic aspects of this condition in a pediatric gastroenterology unit. We reviewed 61 patients (median age of 3.25 ± 4.7 years). The most frequently ingested objects were coins (26.23%), unidentified metal objects (13.11%), bones (8.19%), batteries, and buttons (6.55%). The clinical features we encountered included abdominal pain (55.73%), vomiting (34.42%), and asymptomatic children (29.5%). Routine X-ray examination enabled finding the foreign body in 42 of the cases. An esophagogastroduodenoscopy was performed within 24–72 hours. 25 cases resulted in a negative endoscopy (40.98%), 19 objects (31.14%) were removed using a polypectomy snare, and extraction failure occurred in 17 patients (27.86%). 28 foreign bodies were passed without incidents; in 14 cases, the swallowed objects were never found. In one case, a battery was stuck in the esophageal folds and led to tracheal-esophageal fistula and bronchopneumonia and later to esophageal stenosis. We report a large proportion of foreign bodies that could not be identified or removed due to lack of early endoscopy and poor technical settings. Batteries and sharp objects lead to severe complications and preschool-age children are at high risk for such events.

Biochemical Modifications Study of Cerebral Metabolites by Spectroscopy in Epilepsy Treatment

“…Concerning the MR Spectroscopy, our obtained results are in line with some other existing studies. So, concerning the group with temporal lobe epilepsy, NAA changes were specific to the epileptogenic zone [1][2][3][4][5][9][10][11][12].…”

“…Relatively little research has been conducted concerning the investigation of the biochemical brain metabolites through MR Spectroscopy in children and adolescents with epilepsy [1][2][3].…”

Injuries due to foreign body ingestion and insertion in children: 10 years of experience at a single institution

“…The symptoms also varied depending on the location and size of the FB as well as the age of the patient. The majority of ingested FBs passed spontaneously through the gastrointestinal tract without causing injury . However, some FB ingestions can cause serious complications, such as intestinal perforation and intestinal obstruction, which might require surgical intervention .…”

Evaluation of Gastrointestinal Foreign Body Cases

“…Ancak iğne, çengelli iğne, toplu iğne, tel, tavuk kemiği, balık kılçığı, kürdan, diş protezi, takı ve kenarları çıkıntılı oyuncak parçaları gibi sivri cisimler ise küçük boyutlarda olsalar bile sıklıkla özofagusa bir yerde takılıp kalabilirler (2)(3)(4)(5). Özofagusa yabancı cisim kaçan olgular genellikle 10 yaşın altında ve sıklıkla 1-3 yaş civarındaki erkek çocuklarda görülmektedir (2,(6)(7)(8). Bunun nedeni bu yaş grubundaki çocukların nesneleri daha sık ağzına götürerek tanımaya çalışması ve dişlerin yeterince gelişmemiş olduğundan kaygan damaktan özofagusa kaçması şeklinde açıklanabilir (5)(6)(7).…”

“…Özofagusa yabancı cisim kaçan olgular genellikle 10 yaşın altında ve sıklıkla 1-3 yaş civarındaki erkek çocuklarda görülmektedir (2,(6)(7)(8). Bunun nedeni bu yaş grubundaki çocukların nesneleri daha sık ağzına götürerek tanımaya çalışması ve dişlerin yeterince gelişmemiş olduğundan kaygan damaktan özofagusa kaçması şeklinde açıklanabilir (5)(6)(7). Birçok yabancı cisim, özellikle düzgün kenarlı ve küçük ebatlı, GİS'e zarar vermeksizin doğal yolla çıkması beklenir (1)(2)(3)(4)…”