Foreign body ingestion in children: Beware of disk batteries and multiple magnets

Quitadamo, Paolo; Anselmi, Federica; Caldore, Mariano; Caruso, Flora; Bucci, Cristina; Monaco, Casimiro Del; Tipo, Enzo; Gaglione, Giovanni; Illiceto, M.T.; Esposito, Francesco; Dolce, Pasquale; Ziparo, Chiara; Nardo, Giovanni Di

doi:10.1111/apa.15957

Cited by 8 publications

(6 citation statements)

References 5 publications

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“…In this time interval, a decrease in hospitalization due to magnet ingestion followed by a new increase in the cases was observed [6,7]. In 2015, the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) first and then a jointed European Society Gastrointestinal Endoscopy (ESGE)/European Society for pediatric gastroenterology Hepatology and Nutrition (ESPGHAN) commission issued guidelines on removing foreign bodies in the pediatric population, including magnetic objects [8][9][10][11]. In the case of a single magnet, small enough to pass through the gastrointestinal tract, a more conservative approach can be used to manage the patient in an outpatient setting and facilitate magnet progression with polyethylene glycol.…”

Section: Discussionmentioning

confidence: 99%

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

et al. 2022

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Ingestion of magnetic foreign bodies in pediatric settings has become more common in the last years due to the marketing of various toys containing small magnetic parts. Most magnets, especially if a single element is ingested, usually pass through the gastrointestinal tract without complications. However, ingestion of multiple magnets or magnets and small metallic components may require a prompt intervention due to the risk of attraction across bowel layers, leading to pressure necrosis, perforation, and even death. Routinely, serial radiological evaluations are needed to follow the progression of magnets through the intestine, while the role of small bowel ultrasound is regarded as marginal. Here we report a case of a 5-years old boy who ingested 8 magnets and in which small bowel ultrasound was pivotal for the correct assessment of magnets location to correct address the surgical approach.

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Section: Discussionmentioning

confidence: 99%

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

et al. 2022

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“…EFI is a relatively common condition in adults, with an estimated incidence of 13/ 100,000, whereas data concerning the prevalence of EFI in children are lacking. [1][2][3][4] Several anatomic and functional abnormalities of the esophagus may result in food impaction in children, including eosinophilic esophagitis (EoE), stricturing peptic esophagitis, esophageal congenital strictures, esophageal anastomotic strictures in children with surgically repaired esophageal atresia, esophageal dysmotility, achalasia and extrinsic compression of the esophagus. [5][6] Moreover, behavioral factors may also lead to food bolus impaction and include eating quickly and inadequate chewing of food.…”

Section: Introductionmentioning

confidence: 99%

Esophageal food bolus impaction in pediatric age

Quitadamo,

Pascarella,

Gragnaniello

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesEsophageal food impaction (EFI) is the sudden onset of dysphagia that occurs when a food bolus becomes lodged in the esophagus, requiring endoscopic removal. Scientific data on the prevalence and causes of EFI in children is lacking. The aim of this study was to provide further insights into EFI episodes in children.MethodsWe have prospectively enrolled all children admitted for a first episode of EFI between March 2018 and March 2023. A fluoroscopic contrast study was performed in all patients to confirm the boluses and assess their position. Boluses were extracted by esophagogastroduodenoscopies, and esophageal biopsies were routinely obtained for histologic evaluation.ResultsOver the study period, 41 children were admitted for a first episode of food impaction. Drooling was the most commonly reported symptom. Half children experiencing a first episode of food bolus were diagnosed with EoE (20/41, 48.8%). Almost a fourth of the episodes subtended a different condition, such as esophageal anastomotic, peptic or congenital strictures, stricturing caustic esophagitis, esophageal duplication, and achalasia. In the last fourth of patients the cause of EFI was not identified and thus probably related to quick eating and inadequate chewing of food.DiscussionOur study represents the largest known series of pediatric patients evaluated for food bolus impaction. Our main finding is the high frequency of EoE, which accounts for a half of EFI episodes in pediatric age, especially in older children. This finding highlights the importance of obtaining esophageal biopsies after the endoscopic bolus removal in children with EFI to provide a complete diagnostic evaluation.

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“…Among foreign body ingestions, disc battery ingestion is the most challenging clinical scenario. Despite industry progress in creating more secure battery compartments and making hazard warnings visible, cases of major morbidity and mortality continue to be reported 1–5 …”

Section: Introductionmentioning

confidence: 99%

“…Despite industry progress in creating more secure battery compartments and making hazard warnings visible, cases of major morbidity and mortality continue to be reported. [1][2][3][4][5] Given their local corrosive power, disc batteries pose an imminent health threat when ingested. Once retained in the gastrointestinal tract, they can shortly create a full-thickness erosion.…”

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Disc battery ingestion in paediatric age

et al. 2022

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Aim The aim of the present study was to analyse clinical data of children referred for disc battery ingestion in order to assess short‐ and long‐term reported injuries and to identify outcome predictors and trends, define the urgency of intervention and refine treatment guidelines. Methods The records of all children admitted to Santobono‐Pausilipon Children's Hospital, Naples, Italy for disc battery ingestion from January 2016 to December 2020 were retrospectively reviewed. Odds ratio were computed to assess the association between the different study variables and the rate of complications. Results We enrolled 118 children. Mild to major complications related to the ingested disc batteries were reported in 12/118 (10.2%) patients. Disc battery oesophageal retention, disc battery diameter >20 mm, together with age below 1 year and symptomatic presentation were the most important factors associated with poor clinical outcome. Conclusion Our data confirm that ingested disc batteries are a serious health hazard and require a timely and qualified medical evaluation. We have identified three predictors of outcome severity: oesophageal retention, large‐diameter cells and symptom onset. Disc batteries lodged beyond the oesophagus appear substantially harmless and we may support a more conservative approach.

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Foreign body ingestion in children: Beware of disk batteries and multiple magnets

Cited by 8 publications

References 5 publications

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

Value of intestinal ultrasound in pediatric magnet ingestion: a case report

Esophageal food bolus impaction in pediatric age

Disc battery ingestion in paediatric age

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