Foreign body ingestion in children: adult gastroenterologist's experience

Aims Ingestion of foreign bodies are relatively common in paediatric populations, with a peak between the ages of 6 months and 6 years. Due to the lack of pediatric endoscopists in our hospital, this study presents the epidemiological and aetiological characteristics and the management of these patients by a team of adult endoscopists [1].

Methods We performed a retro-prospective single institution study during 2 years investigating the presentation, aetiology, and management of children (aged less than 18 years) who were admitted for true foreign body ingestion.

Results Out of 2100 esogastroduodenoscopy (EGD) performed, 78 were performed on children (2.8%). 13 out of 78 children were admitted as an emergency (16.7%) and 8 for true foreign body ingestion (10.2%). There were 6 boys and 2 girls with a mean age at presentation of 3.4 y.o [11months – 5 y.o]. The presentation delay to the emergency department was 1 to 4 hours. On average, the endoscopist was called 2 hours after the patient's admission. The delay between admission and endoscopic examination was 2 to 12 hours. 7 children were asymptomatic and one had aspiration syndrome. The chest x-ray, both in the frontal and in the lateral view, allowed the diagnosis of esophageal foreign body in all cases : 4 in the middle esophagus and 2 in the upper esophagus.

At EGD foreign bodies found were:

3 button batteries and 3 coins that were located in the esophagus (7.7%)

1 dental drill in the stomach

1 piece of glass was not found suggesting it passed through the digestive system.

For two patients who had swallowed button batteries, delay in presentation to the emergency room (> 4 hours) was responsible for esophageal ulcers with necrosis.

Foreign bodies were successfully removed during EGD in all patients (100%) without complications, 4 with grasping forceps and 3 with retrieval net. None required surgery.

For button battery ingestions, short-term evolution was favorable with good tolerance of oral feeding. The follow-up endoscopic examination was performed on day 8 and at the 4th week and showed very good endoscopic improvement with regression of the initial lesions.

Conclusions Gastrointestinal endoscopic emergencies are rare in children. In our unit, foreign body ingestion was the most common indication for emergency EGD (10.2%).Esophageal foreign body was the most common location (7.7%).

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. Kramer RE, Lerner DG, Lin T, Manfredi M. et al. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Endoscopy Committee. J Pediatr Gastroenterol Nutr 2015; 60 (4): 562-74 PMID: 25611037

Publication History

Article published online:
27 March 2025