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

Ishak, Luqman Afiq Mohamad; Khor, Kee Guan; Tan, Shi Nee

doi:10.1002/ped4.12149

Cited by 3 publications

(5 citation statements)

References 8 publications

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“…FB ingestion is often a difficult diagnosis in the paediatric population. [ 9 ] The ingestion may not be witnessed by the caregiver and small children may not vocalise: a high index of suspicion is therefore required to make a diagnosis. Many cases of FB ingestion are not brought to medical attention probably because most of the foreign bodies are passed spontaneously in stool.…”

Section: Discussionmentioning

confidence: 99%

Foreign Body in the Gastrointestinal Tract in Children: A Tertiary Hospital Experience

Emeka,

Chukwuebuka,

Tochukwu

2023

African Journal of Paediatric Surgery

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Background: Foreign body (FB) ingestion in the gastrointestinal tract (GIT) in children is common. Although most foreign bodies will pass spontaneously, surgical intervention is required when they fail to pass. Aims and Objectives: The aim of this study was to evaluate our experience in the management of children who presented with FB in the GIT. Materials and Methods: This was a retrospective study of children that underwent laparotomy for the removal of FB in the GIT at the paediatric surgery unit of Enugu State University Teaching Hospital, Enugu over a 10-year period. Results: A total of 272 children presented with FB in the GIT during the study period, out of which 30 patients had laparotomy. This gave an operative incidence rate of 11%. There was a slight male predominance and the ages of the patients ranged from 6 months to 5 years (median 3 years). About half of the patients had no symptoms and all the patients were investigated with an abdominal radiograph. Only one-third of the patients had a predisposing factor that could have led to FB impaction. FB impaction was the most common indication for surgery, and enterotomy with FB removal was the most performed surgical procedure. The most common FB removed were tiny parts of toys, and the most common post-operative complication was surgical site infection. There was no mortality. Conclusion: FB in GIT in children could be associated with complications that require surgical treatment. FB ingestion is preventable. Focus should be placed on caregivers preventing children from ingesting FB.

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Section: Discussionmentioning

confidence: 99%

Foreign Body in the Gastrointestinal Tract in Children: A Tertiary Hospital Experience

Emeka,

Chukwuebuka,

Tochukwu

2023

African Journal of Paediatric Surgery

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“…However, it was manifested in prior studies that FB deposition in duodenal loop was extremely rare although could be severely catastrophic [12] , [13] , [14] , [15] . Although some authors claimed of that ingestion of FB was asymptomatic in over 55% of cases, opponents reported vomiting, drooling, nausea, sensation of FB, pain, dysphagia, hematemesis, stridor, cough, wheezing, organ perforation, and even death could be seen in most cases [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [13] , [14] , [15] , [16] , [17] . Logically presentation of any specific symptom is directed to anatomical region of lodgment [6] , [7] , [8] , [9] , [10] .…”

Section: Discussionmentioning

confidence: 99%

“…When the diagnosis is suspected the next step is radiologic study. Routinely plain x-ray roentgenogram study of neck, chest, and abdominopelvic areas could illustrate the lodgment zone of ingested FB if it is not radiolucent [8] , [9] , [17] . Clinical management of whether ingested or aspirated FB related to passed time of ingestion, type of FB, symptoms, and age of the patient.…”

Section: Discussionmentioning

confidence: 99%

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Duodenal dislodgement of an ingested sharp foreign body by mucosal unfolding “Gilan maneuver”; A novel surgical approach

Baghi

Pirooz

Ebrahimian

et al. 2022

International Journal of Surgery Case Reports

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Introduction and importance Foreign body (FB) ingestion is a common challenge for pediatric health care providers globally. Although endoscopic approach for FB extraction is recommended, surgery remains life giving specifically in developing countries. We presented a novel surgical approach called ‘Gilan maneuver’ for removal of FB which lodged in duodenal loop. Case presentation An eighteen months old male infant referred to emergency department while he lied on his mother's arm. Parents stated their son has ingested a sharp metallic pointy thick needle which applies for cattle injection. On examination mid epigastric tenderness was remarkable. Laboratory finding was normal. Plain thoracoabdominal radiologic study confirmed the diagnosis. Patient underwent explorative laparotomy and the needle was removed through ‘Gilan maneuver’ in which mucosal unfolding of duodenal loop facilitated dislodgement of the FB and it was extracted on the jujenal side. Clinical discussion Duodenal lodge of sharp FB is rare and could be masked by gastric deposition diagnosis. Mucosal folding, narrow luminal diameter, retroperitoneal adherence, and hard surgical anatomy of the duodenal loop make both sharp and large FBs spontaneous dislodgement and favorable surgical outcome relatively unanticipated. Conclusion Despite rarity of duodenal deposition of FB it is possible and could be harmful due to adjacent unforgiving organs. Although endoscopic extraction of FB is generally recommended in guidelines, surgical approach is safe and could be considered.

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“…Objects were retrieved by video-flexible endoscope using rath tooth forceps under sedation. Ishak et al 33 detected a piece of phone screen protector, suspended at the vallecular region of an eight-month infant. The FB as a radiolucent object could not be tressed by X-Ray imaging.…”

Section: Reported Spontaneousmentioning

confidence: 99%

Oral ingestion of foreign body in neonates and infants: A review

Behera,

Rath,

Sahoo

et al. 2024

PJMS

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Foreign body (FB) ingestion in adult and children population is not uncommon but accidental. Same is rare in neonates and infants. Many of FB ingestion go unnoticed or unexpressed if baby is preverbal. Most of the foreign bodies pass spontaneously per anal. Only the larger size or sharp FBs get stuck in places of gastro intestinal tract and presented on emergency Department. Similarly corrosive and toxic FB also invites immediate attention. Literature on the clinical aspects of the foreign body ingestion among neonates and infants was searched electronically through PubMed and individual study. Relevant articles were reviewed thoroughly and summarized. Instances of foreign body ingestion (FBI) in neonate and adult are in ascending trend over last several years. Imaging and identification of radiolucent FBs become challenging for surgeons. Conservative treatment for spontaneous evacuation, endoscopic retrieval and surgical removal are the modalities for FBI management. Two relevant rare reports are appended as the case study. Where the reported FBs are gold fingering and sharp open safety pin in infants. One was managed conservatively for per anal evacuation and other needed endoscopic retrieval with general anesthesia.

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

Cited by 3 publications

References 8 publications

Foreign Body in the Gastrointestinal Tract in Children: A Tertiary Hospital Experience

Foreign Body in the Gastrointestinal Tract in Children: A Tertiary Hospital Experience

Duodenal dislodgement of an ingested sharp foreign body by mucosal unfolding “Gilan maneuver”; A novel surgical approach

Oral ingestion of foreign body in neonates and infants: A review

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