Approach to Pediatric Esophageal Foreign Body Ingestion

Abstract

Background: Foreign body (FB) ingestion is a frequent home accident in the pediatric population and is one of the leading causes of morbidity and mortality in children. We aimed to describe the problem of pediatric esophageal FB ingestion at King Abdulaziz University Hospital over 10 years regarding patient, visit, and management characteristics and identify the pediatric specialty team that was called first to the emergency department in such cases. Materials and Methods: This retrospective study included 117 pediatric patients admitted for esophageal FB ingestion in a tertiary care center in Saudi Arabia from 2011 to 2020. We used Chi-squared and one-way analysis of variance tests to determine the associations. Data on demographic and clinical variables were compared between patients with and without neurodevelopmental disabilities, and their associations were assessed. Results: The mean age of patients was 4.7 ± 3.7 years, with slightly higher rates in males (57.3%). Six patients (5.1%) had a history of preexisting esophageal conditions, and five (4.3%) had previous FB ingestion. The most commonly ingested item was a coin (n = 53) and was mostly located in the upper esophagus (n = 56). Gastrointestinal and respiratory symptoms occurred in 78 and 29 patients, respectively. The Otolaryngology Department contributed the highest number of admissions (63.8%). Conclusion: FB ingestion is common in Saudi Arabian preschoolers. These data indicate the need for caregivers to be educated about FB ingestion. Additional investigations should emphasize addressing the consequences of FB ingestion.

Pediatric foreign body ingestion in Makkah, Saudi Arabia

“…Coins were the most frequent FBs (48.2%), and most FBs (63.6%) affected the upper esophagus. 9 Similarly, a study from the Jazan region showed that 68.5% of FBs ingested were coins. They also found that the incidence of removal of coin FB ingestion markedly increased after coin currency implementation from 16.1% of all cases to 83.9%.…”

“…Coins are commonly located at C1-C6, thereby confirming a highly statistically significant relationship between FB type and CXR characteristic findings, as the sensitivity to detecting coins in x-rays was 100%, which is consistent with the findings of other studies. 9,16 In other studies, the FB was not visualized by x-ray in 43% of cases, and this was related to the different characteristics of the FB. 13 The need for intervention depends on the characteristics of the ingested FB, time of impaction to decrease complications, and location.…”

“…This may be due to differences in the type, size, and location of FB; variable time until hospital admission (as many parents try to manage at home first and others require time to reach the hospital); median time between consultation and extraction; clinical presentation; and presence of other morbidities, as discussed in the literature. 7,9 Others have reported esophageal perforation as a complication from sharp FB ingestion in one patient (among 76) who underwent upper endoscopy. 7 Practical and rapid management strategies are advised to reduce the possibility of complications.…”