Foreign Body Ingestion in Children

Abstract

Foreign body (FB) ingestion in children is common and most children are observed to be between 6 months and 3 years of age. Although most FBs in the gastrointestinal tract pass spontaneously without complications, endoscopic or surgical removal may be required in a few children. Thus, FB ingestion presents a significant clinical difficulty in pediatric gastroenterological practice. Parameters that need to be considered regarding the timing of endoscopic removal of ingested FBs in children are the children’s age or body weight, the clinical presentation, time lapse since ingestion, time of last meal, type as well as size and shape of the FB, and its current location in the gastrointestinal tract. Esophageal button batteries require emergency removal regardless of the presence of symptoms because they can cause serious complications. Coins, magnets, or sharp FBs in the esophagus should be removed within 2 hours in symptomatic and within 24 hours in asymptomatic children. Among those presenting with a single or multiple magnets and a metallic FB that have advanced beyond the stomach, symptomatic children need a consultation with a pediatric surgeon for surgery, and asymptomatic children may be followed with serial X-rays to assess progression. Sharp or pointed, and long or large and wide FBs located in the esophagus or stomach require endoscopic removal.

Foreign body ingestion in an infant: A high index of suspicion is required

“…A meticulous history and thorough examination should be performed to exclude the diagnosis of a foreign body ingestion . In our patient, the main symptom mimicked acute gastrointestinal tract infection .…”

“…Foreign body ingestion should always be suspected in young patients. Foreign bodies usually pass harmlessly through the gastrointestinal tract but a few become lodged at various levels of the respiratory or digestive tract . The most common site of lodgement is at the level of the cricopharyngeus …”

“…However, plain radiography is limited to radiopaque objects . Endoscopic techniques are proven diagnostic tools to evaluate foreign body ingestion . We performed bedside flexible laryngoscopy in our patient to rule out an ingested foreign body.…”

“…Coins, marbles, buttons, toys, jewelry, pins, and bones are the typical ingested foreign bodies in pediatric patients . Coins are the most common foreign body lodging in the throat …”

“…The incidence of foreign body ingestion in the upper gastrointestinal tract accounts for 75%–85% of foreign body ingestions in pediatric patients . Children of any age group may ingest a foreign body; however, most incidents occur in children aged 6 months to 3 years . Clinical symptoms may vary according to the type, size, composition and site of lodgement of the foreign body.…”