Foreign-Body Ingestions of Young Children Treated in US Emergency Departments: 1995–2015

Abstract

OBJECTIVES: To describe the epidemiology of foreign-body ingestions (FBIs) of children <6 years of age who were treated in US emergency departments from 1995 to 2015. METHODS: We performed a retrospective analysis using data from the National Electronic Injury Surveillance System for children <6 years of age who were treated because of concern of FBI from 1995 to 2015. National estimates were generated from the 29 893 actual cases reviewed. RESULTS: On the basis of those cases, 759 074 children <6 years of age were estimated to have been evaluated for FBIs in emergency departments over the study period. The annual rate of FBI per 10 000 children increased by 91.5% from 9.5 in 1995 to 18 in 2015 (R2 = 0.90; P < .001). Overall, boys more frequently ingested foreign bodies (52.9%), as did children 1 year of age (21.3%). Most children were able to be discharged after their suspected ingestion (89.7%). Among the types of objects ingested, coins were the most frequent (61.7%). Toys (10.3%), jewelry (7.0%), and batteries (6.8%) followed thereafter. The rates of ingestions of those products also increased significantly over the 21-year period. Across all age groups, the most frequently ingested coin was a penny (65.9%). Button batteries were the most common batteries ingested (85.9%). CONCLUSIONS: FBIs remain common in children <6 years of age, and their rate of ingestions has increased over time. The frequency of ingestions noted in this study underscores the need for more research to determine how best to prevent these injuries.

Increase of foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

“…The analysis of 1199 accidental paediatric foreign body and chemical substance ingestions over thirteen years (2005-2017) at a German University Medical Centre revealed a signi cant increase in the annual case rate of 80% to about 11 per 10.000 children in the catchment area. This has also been reported in the United States with an annual increase of 91.5% from 9.5 in 1995 to 18 per 10.000 children with FBI in 2015 [7]. In contrast, considerably less FBI have been reported at Chiang Mai University in Thailand (only 194 cases from 2006 to 2017) with a population comparable to Ulm.…”

“…the world [2,3,6,25,26]. A variety of foreign bodies is ingested of which coins appear the most common in our cohort like in many other studies [2,7,25,27,28]. However, the share was lower in our study (18%) compared to 49 to 88% reported by others, which may also re ect changes over time, differences in referral, selection and inclusion of the patients or classi cation and localization of objects as well as different diets and habits of the populations [2,26,[28][29][30].…”

“…Furthermore, the frequency of FBs in different categories vary between study populations, e.g. on second position sh bones were reported in Hong Kong [25], toys in the U.S. [7], plastics in Japan [31], and metallic objects in our study re ecting differences in the surrounding of children, the regional or cultural habits and agedependent preferences in the investigated populations. The ingestion pattern also differs by sex, age and season (e.g.…”

“…The initial assessment includes careful history-taking of symptoms, timing of presentation, type of foreign body or chemical agent, and associated conditions, complemented by physical examination assessing patient status, vital signs, airway evaluation and emergency conditions. Many kinds of objects and toxic substances are reported to be ingested including coins, toys, jewellery, button batteries, magnets, sh bones, household items, household cleaning substances, caustic soda, and many others as well as food impaction [6][7][8][9]. The management depends on the individual presentation of the patient, underlying oesophageal pathology, the ingested object or liquid and its localization as well as on the physician's clinical experience [4,8].…”

Magnetic Apposition across the Epiglottis: Radiographic and Operative Correlation of a Rare Hypopharyngeal Foreign Body

“…While coins, balls, and pearls are some of the more commonly ingested/aspirated items [2], clinicians must maintain a high degree of suspicion for magnets and batteries, due to their potential for serious and even fatal sequelae. A particularly dangerous subset of magnets is small rare-earth magnets such as neodymium magnets, which are substantially stronger than traditional ferrite magnets [3,4]. Ingestion of multiple of these "supermagnets" is of special concern, as they can attract through intestinal walls, resulting in pressure necrosis, fistulization, and bowel perforation [5][6][7].…”