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

Abstract

Background Children with a history of caustic or foreign body ingestion (FBI) seem to be presenting more frequently to emergency departments. This study aims to elucidate the clinical presentation, diagnostic procedures, and complications associated with the ingestion of different object categories over a 13-year time period. Methods A structured retrospective data analysis of patients who presented between January 2005 and December 2017 to the University Medical Centre Ulm was performed. Patients up to 17 years of age with food impaction or foreign body or harmful substance ingestion were included by selection of the corresponding International Statistical Classification of Diseases and Related Health Problems (ICD10-GM) codes. Descriptive statistics, parametric or non-parametric tests, and linear regression analysis were performed. Result In total, 1199 patients were analysed; the mean age was 3.3 years (SD 3.12; range 7 days to 16 years), the male to female ratio was 1.15:1, and 194 (16.2%) were hospitalized. The number of patients seen annually increased from 66 in 2005 to 119 in 2017, with a rise in percentage of all emergency patients from 0.82% in 2010 to 1.34% in 2017. The majority of patients (n = 619) had no symptoms, and 244 out of 580 symptomatic patients complained of retching or vomiting. Most frequently, ingested objects were coins (18.8%). Radiopaque objects accounted for 47.6%, and sharp objects accounted for 10.5% of the ingested foreign bodies, both of which were significantly more often ingested by girls (p < 0.001 for both). Button battery ingestion was recorded for 63 patients with a significant annual increase (R2 = 0.57; β = 0.753; p = 0.003). The annual rate of complications also increased significantly (R2 = 0.42; β = 0.647; p = 0.017). Conclusion We found an alarming increase in the number of children who presented to our emergency department with FBI and associated complications. A standardized diagnostic and therapeutic approach may reduce and prevent serious complications. Further preventive measures within the home environment are needed to stop this trend.

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

“…FB ingestion or aspiration in pediatrics is commonly seen by health care providers worldwide. Its incidence, numbers of emergent cases and complications have increased recently [3] , [13] . The latter could be due to various reasons including growth of population, increased numbers of children in each family, parents' inadequate time to spend for their children, change in life style, and more production of battery operated toys [1] .…”

“…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] .…”

“…Foreign body(FB) ingestion in pediatric population is a common challenge for surgical teams all around the world [1] , [2] , [3] . The incidence of ingesting FB has raised recently.…”

“…Involved cases increased near the double from 2005 to 2017. Concurrently need to perform emergent intervention raised from 0.8% to 1.3% in recent decade [1] , [3] . According to previous studies, it seems the most susceptible age for FB ingestion is from 6 months old to 3 years although data is variable in regard of the upper limit [4] , [5] , [6] , [7] .…”

Fallberichte: Kinder mit tracheoösophagealer Fistel nach Knopfbatterieningestion

“…Kleinkinder sind besonders häufig betroffen, weil die großen Knopfbatterien (CR2032) in dieser Altersgruppe leichter in der Speiseröhre steckenbleiben können 10 , 11 . In einer retrospektiven Studie stieg die jährliche Inzidenz in den Jahren 2005 bis 2017 signifikant an 12 . Das National Capital Poison Center der USA berichtete über 68 tödliche Komplikationen nach Ingestion einer Knopfzelle im Zeitraum von 1977 bis 2021 13 .…”