Foreign Body Ingestion in Children.

Introduction: Foreign body ingestion in children is a common pediatric emergency that can result in serious complications if not managed promptly. Observation: it is a case report of an 18-month-old infant who ingested a knife while playing with his 3-year-old sister. The patient was stable but required a surgical approach due to the size of the object and the risk of esophageal injury during removal. Discussion: Children between 6 months to 3 years are at the highest risk for foreign body ingestion. The most common foreign bodies ingested by children are small objects such as coins, toys, magnets, button batteries, and small parts of other objects. Symptoms can vary depending on the type and location of the foreign body and can range from choking, difficulty breathing, and vomiting to blood in stool or vomit and fever. Sharp and elongated objects, as well as batteries and magnets, can cause life-threatening complications such as airway obstruction, esophageal perforation, or bowel obstruction. The approach to management depends on the type and location of the foreign body, and preventing foreign body ingestion in children is critical to avoiding the need for management. Various measures, such as keeping small objects out of reach, providing age-appropriate toys, and supervising young children during playtime, can be implemented to prevent foreign body ingestion in children. Conclusion: Foreign body ingestion is a common pediatric emergency that can lead to serious complications if not managed promptly. Prevention is key in reducing the incidence of foreign body ingestion in children.

Introduction: Foreign body (FB) ingestion in children is a common problem worldwide. Peak incidence is between the ages of 6 months to 4 years and children usually pass the object spontaneously without any symptoms. Objective: To assess the pattern of FB ingestion in the Sri Lankan context. Method: A descriptive cross sectional study was conducted from April to September 2010 at a leading tertiary care hospital. Data was collected by interviewer administered questionnaire and reviewing Bed Head Tickets. Results: Peak incidence of FB ingestion occurred between one to four years of age (50.4%) with a slight male predominance (56.6%). None of the children were mentally challenged. Five of the children who presented with a history of ingestion had aspirated the FB and all of them required bronchoscopy to remove the object, one child also requiring intensive care unit admission. All the aspirated objects were food particles. Button battery (24.5%) and coins (17.0%) were the commonly ingested foreign bodies. Common source of button battery was the toys with which they were playing. More than half presented to the hospital asymptomatically. One third of children notified their parents about the ingestion. Expectant management was offered to 66% of the children and all of them recovered uneventfully without any intervention. Upper gastrointestinal endoscopy was used in 12 (22.6%) children to remove the FB.Conclusions: Commonest source of FB was button batteries from toys. Most children ingested the FB despite mother’s care. Although most FB ingestion could be managed expectantly, offering appropriate intervention at the correct time prevents complications. Patient presenting with a history of FB ingestion may have aspirated the FB. As aspirated FBs are associated with significant complications, a high degree of suspicion is needed to differentiate ingestion from aspiration.Sri Lanka Journal of Child Health, 2014; 43(2): 88-91(Key words: Foreign body ingestion; children; Sri Lanka)DOI: http://dx.doi.org/10.4038/sljch.v43i2.7009

PurposeForeign body (FB) ingestion is common in children, and button battery (BB) ingestion has been increasing in recent years. This study was to identify factors related to outcomes of FB ingestion, particularly BBs in the stomach. We evaluated whether the current recommendations are appropriate and aimed to suggest indications for endoscopic removal of BB in the stomach in young children.MethodsWe investigated patient age, shape, size, location of FBs, spontaneous passage time and resulting complications among 76 children. We observed types, size, location of BB and outcomes, and analyzed their associations with complications.ResultsCoins and BB were the two most common FBs. Their shapes and sizes were not associated with the spontaneous passage time. Size, spontaneous passage time, and age were also not associated with any specific complications. For BB ingestion, all 5 cases with lithium batteries (≥1.5 cm, 3 V) presented moderate to major complications in the esophagus and stomach without any symptoms, even when the batteries were in the stomach and beyond the duodenum, while no complications were noted in 7 cases with alkaline batteries (<1.5 cm, 1.5 V) (p=0.001). All endoscopies were conducted within 24 hours after ingestion.ConclusionThe type and voltage of the battery should be considered when determining whether endoscopy is required to remove a BB in the stomach. For lithium battery ingestion in young children, urgent endoscopic removal might be important in order to prevent complications, even if the child is asymptomatic and the battery is smaller than 2 cm.

Background: The incidence of multiple magnetic foreign body (MMFB) ingestion in children is rising, which poses a serious risk for gastrointestinal tract injury. In the current study, the clinical characteristics were analyzed to enhance awareness among parents and caregivers, treatment experiences were summarized and discussed, and optimal treatment plans were identified. Methods: A retrospective analysis was performed on 130 pediatric patients with MMFB ingestion at the Children's Hospital Affiliated with Zhejiang University School of Medicine, between June 2016 and June 2023. The clinical data, treatment details, and patient prognosis were systematically collected. Results: Forty-one patients were managed conservatively, while 89 patients underwent open surgery. Among the 44 patients who were treated with laparoscopic surgery, conversion to laparotomy was necessary in 28. The risk of gastrointestinal perforation was higher in symptomatic children than in asymptomatic children (chi-square value: 37.156; P < .001). Perforations were mainly observed in the small intestine. The median length of hospital stay was 10 days in the cohort of 16 children who underwent laparoscopic surgery successfully, which differed from the group of 28 children who were converted to a laparotomy (10 days [interquartile range, or IQR: 9-12.75 days] versus 12 days [IQR: 10-15.75 days]; P < .05). Conclusions: The ingestion of MMFBs in children can lead to severe injuries, underscoring the importance of early detection and treatment. Tailored clinical management strategies should be implemented based on individual conditions, while prompt and effective interventions can minimize harm. Therefore, we propose a comprehensive framework for individualized treatment processes.

Background: Swallowing foreign bodies represents a significant global medical emergency, occurring both intentionally and accidentally. Objectives: This study investigates the prevalence and treatment outcomes of foreign body ingestion (FBI) in children treated at Ali Ibn Abi Talib Zahedan Hospital's emergency department in 2020. Methods: This descriptive cross-sectional study involved 61 children identified from all those presenting to Ali Ibn Abi Talib Zahedan Hospital's emergency room in 2020 with confirmed FBI based on history or radiological findings. Data were collected using an information sheet, and analysis was conducted using SPSS 26 software. Results: The study found the highest frequency of cases among children aged up to 4 years (57.4%), predominantly boys (60.7%). Mothers most commonly witnessed the incidents (24.6%). Batteries (29.5%) and coins (13.1%) were the most frequently swallowed foreign bodies. Most mothers had a diploma or sub-diploma education (78.7%), and the majority were housewives (85.2%). Medical treatment was most common (72.1%), with 23% discharged spontaneously. Complications included perforation (8.2%). Most fathers were self-employed (65.6%). Conclusions: This study underscores the prevalence and treatment outcomes of FBI in children, emphasizing the need for prompt diagnosis and appropriate management strategies.

Foreign body ingestion and foreign body aspiration commonly affect young children between 6 months and 6 years. A large number of these events remain unwitnessed and asymptomatic while the swallowed foreign body traverses the gastrointestinal tract and is passed in the stool. Recent literature has shown an increase in morbidity associated with button battery and (neomydium) magnet ingestions in children, particularly over the last decade. Early identification and management in a time critical manner is required in cases where button batteries get lodged in the oesophagus or multiple magnets are swallowed. Deaths, although rare, have been reported with these dangerous foreign body ingestions in children where diagnoses were delayed. Nurses through their direct contact with children in different clinical settings play a vital role in managing foreign body ingestions.

To evaluate clinical features and endoscopic outcomes in children with high-risk upper gastrointestinal (GI) foreign bodies, stratified by object type. We retrospectively reviewed cases of children who ingested high-risk foreign bodies with upper GI retention at a Chinese tertiary pediatric center (January 2020-December 2024). Patients were stratified by the type of ingested foreign body: sharp objects, magnetic objects, or button batteries. Demographics, symptoms, retention sites, injuries, complications, and outcomes were analyzed. Among 155 children, 61 (39.4%) ingested sharp objects, 42 (27.1%) magnetic objects, and 52 (33.5%) button batteries. All underwent attempted endoscopic retrieval. Groups differed significantly in age, retention site, and ingestion-to-presentation duration (all P < 0.05). Button battery ingestions occurred predominantly in children aged 0-3 years; sharp objects predominantly lodged in the esophagus, while magnets and button batteries were mainly retained in the stomach. Magnetic ingestions had the longest duration (>24 h) because they were often asymptomatic. Pain was more common with sharp and magnetic objects (P < 0.05); vomiting and perforation rates were highest in the magnetic group (P < 0.05), likely because only cases involving ≥2 magnets were included. Dysphagia was more frequent with sharp objects and batteries (P < 0.05). Esophagogastroduodenoscopy (EGD) was first-line with a success rate of 96.1%; two sharp cases needed rigid esophagoscopy, and the magnetic group had higher surgical rates (P < 0.05). High-risk foreign body ingestion is dangerous, especially ingestion of multiple magnetic foreign bodies, which are associated with high perforation and surgical rates. EGD is effective first-line therapy. Urgent intervention is needed for multiple magnets (even asymptomatic) and delayed cases. Post-removal follow-up is important, and our comparative analysis guides risk-stratified management.

Foreign body (FB) ingestion in children is common and most children are observed to be between 6 months and 3 years of age. Although most FBs in the gastrointestinal tract pass spontaneously without complications, endoscopic or surgical removal may be required in a few children. Thus, FB ingestion presents a significant clinical difficulty in pediatric gastroenterological practice. Parameters that need to be considered regarding the timing of endoscopic removal of ingested FBs in children are the children’s age or body weight, the clinical presentation, time lapse since ingestion, time of last meal, type as well as size and shape of the FB, and its current location in the gastrointestinal tract. Esophageal button batteries require emergency removal regardless of the presence of symptoms because they can cause serious complications. Coins, magnets, or sharp FBs in the esophagus should be removed within 2 hours in symptomatic and within 24 hours in asymptomatic children. Among those presenting with a single or multiple magnets and a metallic FB that have advanced beyond the stomach, symptomatic children need a consultation with a pediatric surgeon for surgery, and asymptomatic children may be followed with serial X-rays to assess progression. Sharp or pointed, and long or large and wide FBs located in the esophagus or stomach require endoscopic removal.

Background: The study aimed to demonstrate clinical pictures, diagnostic procedures, and management of foreign body ingestion in the pediatric population. Methodology: In this prospective study conducted between January 2020 and February 2023, a total of 41 consecutive children under the age of 16 who presented to the emergency department or the pediatric gastroenterology and nutrition outpatient clinic were assessed. Regardless of their clinical symptoms, all children underwent radiography within the first hour of arrival, and upper gastrointestinal endoscopy was performed in all of them. Result: Among 41 studied children, 26 (63.4%) were male, and the mean age was 3.5± 4.8 years (10 months to 16 years). 85.4% of the study population (35 children) were below five years of age. The median time interval from foreign body ingestion to hospital arrival was 48 hours. Ingestion was accidental in all cases, and the most common presentation was vomiting (24.4%). The most frequently ingested foreign body was a coin (48.8%), followed by metallic objects (22%), sharp objects (12.1%), plastic (9.8%), large seeds (4.9%), and button battery (2.4%). Foreign bodies were visualized through X-rays in 37 children (90.2%). The stomach (65.9%) was the most common location of foreign bodies. X-ray findings were positive in 90.2% of cases (37 children). Upper GI endoscopy was performed in all cases, and a foreign body was removed in 40 cases that were visualized through the endoscope without any complications. Conclusion: Coins are the most frequently ingested foreign bodies. Both radiology and endoscopy can help in an appropriate diagnosis. Endoscopic removal of a foreign body is safe in children.

The aim of this study is to review the experience on managing foreign body ingestion in children with special emphasis on the endoscopic techniques and specific retrieval devices used for foreign body (FB) extraction. The charts of 341 children were reviewed retrospectively. Demographic data, ingested material, removal technique and tool, level of FB, complications, and outcomes were recorded. A total of 364 FBs were removed from 341 children. Among these, 56.5% (n: 206) were entrapped in esophagus, 39% (n: 142) were in stomach, and 4.5% (n: 16) in duodenum and intestine. The most frequently ingested items were coin (42.5%), button batteries (20.6%), and safety pins (12%). Optical forceps (37.9%) were the most commonly used tool and they were used during retrieval of esophageal FB by rigid endoscopy. Retrieval net (20.7%) was the second most common tool and the most common one during flexible endoscopy. Depending on our experience, we strongly advocate rigid endoscopy for esophageal FBs and food impaction in children because it allows both to use optical forceps with a strong grasping ability for blunt FBs and to position sharp and pointed objects inside the rigid endoscope. We recommend retrieval net as the first tool for the extraction of blunt objects and rat tooth retrieval forceps is the best tool for sharp and pointed FBs in stomach.

Background: Foreign body ingestion is a common event in pediatric population. Children swallow different object including, coins, toys, batteries, etc. Most instances of foreign body ingestion are uncomplicated and the foreign body is excreted spontaneously. In some cases, the foreign body is lodged in the gastrointestinal tract and leads to complications. This study investigated the distribution of foreign body ingestion, and associated complications in a tertiary center of pediatrics. Methods: In this retrospective study, electronic records of patients with diagnosis of foreign body ingestion in two consecutive years in a tertiary center were reviewed. The associated data were extracted and analyzed. Results: 1125 cases were identified. 633(56.3%) patients were male. Median age was 3.7 years. The most common swallowed objects were batteries, followed by coins, and sharp objects. The most common location of foreign body was the esophagus. The median time interval between ingestion and presentation was 4 hr. In patients with disk battery ingestion, there was a significant statistical relationship between time interval and presence of complications. Most patients (84.4%) needed no intervention. 14.9% were managed by a non-surgical intervention, and 0.6% needed surgery. No mortalities were recorded. Two cases of peritonitis were documented, following ingestion of magnets. Eight cases of esophageal burn, and one case of mediastinitis were documented following disk battery ingestion. Conclusion: Foreign body ingestion is a common occurrence in children under 5 years of age. In this study, batteries were the most common swallowed objects. Most serious complications were following batteries, or magnet ingestion. Preventive measures focusing on batteries and high-powered magnets could decrease the incidence of these complications.

Background: Foreign body ingestion is common in children worldwide, and is associated with significant morbidity and occasionally, mortality. The objective of this study was to elucidate the demographics, presentation, management and outcomes for children presenting with ingestion of foreign bodies. Methods: Data were collected for 1202 children up to 16 years of age who presented to Addenbrooke’s Hospital, Cambridge over a 5-year period between 2016 and 2021. Results: The majority of patients were male (n=672, 56%) and the median age was 3.0 years (range 0-15). 75% were under 6 years of age. 165 (13.7%) were infants (&lt;12 months old). 160 (13.3%) patients were admitted, and of those, 95 (60%) required interventions necessitating general anaesthesia. Button battery ingestions were most likely to require general anaesthesia (31%), compared to 17% for coins, 9.5% for magnets and 7.9% overall. Seven patients required laparotomy (including 5 for bowel perforation), all in patients who had ingested multiple magnets. Of particular concern, there was a sixfold increase in the number of magnet ingestions over the period of the study. Conclusion: This study demonstrates the continuing significant morbidity associated with foreign body ingestion in children, with almost 1 in 7 patients being admitted to hospital and 1 in 12 requiring interventions under general anaesthesia. The most serious morbidity is associated with magnet and button battery ingestion. Public campaigns to raise awareness of the dangers of small objects in a child’s environment, particularly magnets, aimed directly at parents and carers, should be made a priority.

Foreign body ingestion in children is a medical emergency, with severe cases posing life-threatening risks. Swallowing blades is an extremely rare and critical emergency requiring immediate medical intervention. The blades may cause perforation or bleeding in the gastrointestinal tract at any time, threatening the patient's life. This case report aims to provide treatment process and experience for dealing with this condition. A 14-year-old girl was hospitalized for swallowing 6 blades. Upon hospital admission, an emergency esophagogastroduodenoscopy was immediately performed. One blade was removed under emergency esophagogastroduodenoscopy, and the other 5 blades had entered the intestine and could not be removed endoscopically. After conservative medical treatment, the rest blades remarkably and naturally passed without surgical intervention. And the patient was discharged from the hospital without obvious discomfort. Ingesting blades might lead to serious or fatal complications that require urgent surgical treatment. Strict medical management and timely assessment of the condition are very important for passage of ingested blades, which may avoid surgical procedures. This report provides valuable insights and guidance for clinicians in the management of patients with swallowing blades.

ObjectiveReevaluation of our experiences in adherence to the established local guidelines in our population of pediatric patients diagnosed with foreign body ingestion.MethodsA retrospective study of patients aged 0-18 years who...

HighlightsWhat are the main findings?Aorto-esophageal fistula (AEF) is a rare but highly lethal complication of foreign body ingestion in children, with button batteries responsible for 67% of cases and an overall 43% mortality rate.The presented case demonstrates the successful use of endovascular covered stent placement as an emergency, life-saving treatment option in a hemodynamically unstable child—an approach rarely reported in pediatrics.Review of 37 cases shows that symptoms are often nonspecific, but sentinel bleeding is the most crucial early warning sign.CT angiography is confirmed as the most accurate modality for detecting vascular complications, while X-rays identify the foreign body but often miss associated injuries.What are the implications of the main finding?Early recognition of AEF—especially when minor bleeding follows button battery ingestion—is essential to prevent fatal outcomes.Endovascular stenting may serve as a rapid, less invasive alternative to emergent thoracotomy in selected pediatric cases, particularly in hemodynamically unstable children.A standardized diagnostic pathway including urgent CT angiography and multidisciplinary coordination could significantly improve survival.Public health measures, safer battery designs, and dedicated AEF registries are needed to reduce incidence, support early diagnosis, and guide evidence-based management.Background: Aorto-esophageal fistula (AEF) is a rare but life-threatening condition in children following foreign body (FB) ingestion, with button batteries (BB) being the most dangerous. These batteries involve severe tissue necrosis due to chemical and electrical reactions, often leading to fistula formation and catastrophic hemorrhage. Appropriate treatment for AEF is still undefined. Method: This report presents a novel case of AEF closure using a covered stent in a 4-year-old boy, complemented by a narrative review of 36 reported pediatric AEF cases from 1988 to 2024. Results: The review revealed that BB ingestion accounted for 67% of AEF cases, with a high mortality rate of 43%, underscoring the critical nature of this condition. Early symptoms are often nonspecific, leading to delayed diagnoses, which worsen outcomes. Computed tomography (CT) is the key imaging modality for detecting vascular complications such as AEF, while X-ray may help identify the foreign body, but is often insufficient to assess associated injuries. While surgical repair remains the mainstay of treatment, minimally invasive techniques, such as endovascular approaches, are emerging as viable options. Conclusions: This study highlights the need for heightened public awareness, safer battery designs, and prompt, multidisciplinary interventions to improve patient outcomes. Future research should focus on refining diagnostic protocols, evaluating innovative management strategies, and establishing comprehensive registries to inform evidence-based guidelines and optimize care.