Foreign Bodies In Children Research Articles

Clinical Features and Management of Urethral Foreign Bodies in Children: A 10-Year Retrospective Study

(1) Background: Urethral foreign bodies (UFBs) are very rare in children, and their treatment remains challenging. (2) Methods: A retrospective analysis was performed on 40 patients who were admitted to our hospital due to UFBs from June 2011 to June 2021. The clinical features and treatment experiences of these children are summarized. (3) Results: A total of 40 children were enrolled in the study, 17 boys and 23 girls. A majority of the boys (median age: 11.8 years) were of puberal age, and the main cause of the UFBs was sexual gratification (94.1%). Girls were almost always in early childhood (median age: 1.8 years), and most of the UFBs were related to specific clothing in specific regions and seasons. Ultrasound had a high accuracy in the diagnosis of female UFBs; the sensitivity and specificity were 88.9% and 85.7%, respectively. Most UFBs could be removed using a cystoscope (82.4% in boys, 100% in girls). All the children had a good prognosis and no complications occurred during follow-up. (4) Conclusions: Ultrasound is a reliable and sensitive method for the diagnosis of UFBs in girls. Cystoscopy is a reliable surgical method for UFBs.

Characteristics of Pediatric Nasal Foreign Body Cases That Required Multiple Removal Procedures: A Single Tertiary Medical Center Cross-Sectional Study.

Removal of nasal foreign bodies in children should be completed as few numbers of times as possible to reduce the burden on the child. This study aimed to reveal the characteristics of pediatric nasal foreign body cases that required multiple removal procedure and to investigate the appropriate removal method for each shape of foreign body. We retrospectively reviewed patients who visited a pediatric emergency department because of nasal foreign body from November 1, 2018, to October 31, 2020. We compared the characteristics of patients, foreign bodies, and treatment between the success and failure groups in the first removal procedure. Moreover, we described the detail of patients in the failure group. We also showed final successful removal methods according to the shape of the foreign bodies. We included 104 children in our analysis. Between the success and failure groups in the first removal procedure, there was no statistically significant difference in the characteristics of patients and foreign bodies but a significant difference in the removal method ( P < 0.001). In the failure groups, the most frequent number of times required for removal is 2 and the most common methods in the first removal procedure was the parent's kiss, most of which were performed on spherical foreign bodies in younger children, Finally, only 7 cases (6.7%) failed to remove the foreign body. According to the shape of the foreign bodies, the percentage of forceps and clamps used for successful removal was high in every shape. There was a significant difference in the removal method between the success and failure groups in the first removal procedure, but finally, most foreign bodies were removed by emergency physicians. Therefore, further research is needed to determine the appropriate removal method for each patient and foreign body.

Prevention of foreign bodies entering Children's respiratory tracts: The effect of the Caregiver's knowledge, behaviour and attitude

ObjectivesTo explore the effect of the caregiver's knowledge, behaviour and attitude on the prevention of foreign bodies in children's respiratory tracts to provide a basis for publicity and education on foreign bodies in children's respiratory tracts. MethodsA case–control method was used to investigate the knowledge, behaviour and attitude of the caregivers of 900 paediatric patients at Hunan Children's Hospital from June 2017 to February 2019. Caregivers of 300 children with foreign bodies removed by rigid bronchoscopy were selected as the case group. Caregivers of 600 children with other conditions were selected as the control group. The knowledge, behaviour and attitude of the caregivers towards foreign bodies in children's respiratory tracts and the demographic characteristics of the two groups were analyzed and compared. ResultsThe results showed significant differences for the children in terms of their gender, age and living conditions between the two groups (all p < 0.05) and for the caregivers in terms of their age, educational level, relationship with the child and the number of children in the family (all p < 0.05). There were statistically significant differences in the caregivers' knowledge of foreign bodies in the respiratory tract between the two groups (p < 0.05). In addition, a significant difference was also found between the groups in the caregivers' understanding of the prevention of foreign bodies in the respiratory tract, such as whether they were aware of the specific first-aid measures needed to treat the condition (p < 0.05). ConclusionThe caregiver's relationship to the child, their age, their level of education and the number of children in the family affected the occurrence of the condition, while the caregiver's knowledge, behaviour and attitude regarding foreign bodies in the respiratory tract also had some influence. However, in the future, national multiple-centre courses could be extremely useful in educating caregivers.

INHALED FOREIGN BODY OR ENDOBRONCHIAL TUBERCULOUS GRANULOMA? : ABOUT A CASE

Tuberculosis is a public health problem. Endobronchial localization of tuberculosis is rare. Its endoscopic aspects are diverse and often misleading and can pose a problem of differential diagnosis such as a tumor or a foreign body in children. Chest CT helps in diagnosis and bronchoscopy remains the most reliable examination with biopsy. early treatment helps to avoid complications including bronchostenosis. We report the case of a tubercular bronchial granuloma in an infant hospitalized in pediatric intensive care for suspected inhalation of a foreign body.

Foreign Bodies in Ear and Upper Aero-digestive Tract in Tertiary Level Hospital

Background: Foreign Bodies (FBs) are the commonest emergencies in Otorhinolaryngology. The most common incidences arein nasal cavity, ears and oropharynx. The most commonly swallowed foreign bodies in children are coins. It was aimed todescribe the nature, types, and location of FB impaction in addition to procedure of anesthesia &amp; management of patients as well. Methods: All patients with history and clinical features of foreign body in otorhinolaryngology in both sexes during the 6months study period constituted the study population. This was a descriptive type of cross-sectional study done in a tertiarylevel hospital (Faridpur Medical College Hospital, Faridpur, Bangladesh). Results: The study was included 58 patients aged 6 months to 72 years were seen (mean: 22.46 years) with 33 males and 25females and a male: female ratio of 1.4: 1. Most common site of impaction were nasal cavity 19 cases (52.6%) then ear 13 cases(22.4%), hypopharynx 9 cases (8.6%),oropharynx 6 cases(10.3%), esophagus 5 cases (8.6%), soft tissue neck 4 cases (6.9%)and larynx 2 cases (3.4%). In this study most common FB was Fish bone 8(13.79%) then coin 5(8.62%). Most of the oro-pharyngeal FBs and nasal FBs were removed directly 33 (56.90%) by naked eye with forceps or FB hook. Only 2 cases (3.40%)nasal FBs were removed by endoscope. Esophagoscopy was done in 14 cases (24.1%).Foreign body soft tissue neck wasremoved with external approach in 4 patients (6.9%).Only in 3 cases microscope was needed to remove foreign body from ear(5.3%).Only in 2 cases (3.4%) laryngoscopy was needed to remove foreign body. FBs from nose &amp; oropharynx mostlyremoved without anaesthesia 25(43.10%) though some FBs from nose &amp; oro-pharynx were removed under local anaesthesiaby using 10% Xylocaine spray. Conclusion: The study findings felt the need for parental health education on object placements, and a high index of suspicionamong practitioners to facilitate early referral and avoid preventable complications.

Airway Foreign Bodies in Children: A Review Article

Foreign body aspiration (FBA) in children represents a significant morbidity and even mortality producing sudden deaths. Regarded as a major public health issue, FBA may be the end result of aspiration of various organic and inorganic materials. Parental and public awareness including preventive measures is important in avoiding these injuries. The consequences of FBA may pose great challenge for both the children, their families together with clinicians dealing with these children. In this review article it is aimed to discuss the epidemiology, clinical presentations, diagnosis and treatment modalities of FBA in children under the light of relevant literature.

Foreign body aspirations in children and adults

ObjectiveForeign body aspiration (FBA) can be encountered in all age groups, especially in children under 3 years of age. In this study, we aimed to evaluate our results in children and adults who underwent rigid bronchoscopy due to a history of foreign body aspiration. Materials and methodsIn a single-center study, 822 consecutive patients with suspected foreign body aspiration and undergoing rigid bronchoscopy between January 2000 and August 2021 in our clinic were retrospectively evaluated. ResultsThere were 451 (54.9%) male and 371 (45.1%) female patients. The mean age was 8.1 ± 14.0 (range 1 month–84 years). 525 (63.9%) of the cases consisted of cases under 3 years old, including 3 years old. There were 726 (88.3%) pediatric patients (≤18 years old), and 96 (11.7%) adult patients. The most important symptoms were cough in 690 (83.9%) cases and wheezing in 492 (59.9%) cases. The most frequently aspirated foreign bodies in children were sunflower seeds (14.2%, n = 71), food particles (11.4%, n = 57) and needles (52%, n = 10.4). The most frequently aspirated foreign bodies in adults were needles (39.5%, n = 28), non-needle metallic objects (21.1%, n = 15) and food particles (11.3%, n = 8). No mortality was observed in any of the patients who underwent rigid bronchoscopy. ConclusionFBA is higher in children and direct radiological findings are less than in adults. Current findings show that FBAs in children are more difficult to diagnose and more dangerous clinically.

Tracheobronchial Foreign Bodies in Children: Experience From 1,328 Patients in China.

Objective:To analyze the clinical characteristics of tracheobronchial foreign body (FB) cases in a pediatric Chinese population.MethodsThe clinical data of pediatric patients aged 0–18 years old diagnosed with a tracheobronchial FB in the Children's Hospital of Chongqing Medical University between September 2018 and August 2021 were analyzed retrospectively.ResultsAmong 1,328 included cases, 92.09% of patients were <3 years old, the male to female ratio was 1.86:1. The prevalence of tracheobronchial FB was similar between patients living in rural and urban areas and tracheobronchial FBs were more common in winter. The most common presenting symptoms were cough and wheezing. The most common CT findings was local obstruction or tracheobronchial narrowing, followed by obstructive emphysema of lung and pneumonia. The 11.3% of cases that did not report FB aspiration on admission had a longer time to hospital admission and longer hospitalization time than cases reporting FB aspiration (P < 0.05). The most common FB type was nuts (81.17%). FBs were more frequently located in the right bronchus, and 64 (4.82%) cases involved multiple FBs. FBs were expelled by coughing in only 4.07% of cases. For the other cases, FB removal by first bronchoscopy in our hospital was successful and complete in 96.86% of cases. 1.51% of patients had hypoxic ischemic encephalopathy (HIE) and the location of FBs was a possible risk factor for HIE (P < 0.05).ConclusionsTracheobronchial FBs occurred most commonly in children <3 years old. If asphyxia occurs in children which FBs aspirated, emergency treatment is needed to reduce the occurrence of HIE. Rigid bronchoscopy remains the first-line method for FB removal in children.

Magnet and button battery ingestion in children: multicentre observational study of management and outcomes.

BackgroundMagnets and button batteries (BBs) are dangerous ingested foreign bodies in children. The scale and consequences of this public health issue in the UK are unknown. This study aims to report the current management strategies and outcomes associated with paediatric magnet and BB ingestion in the UK.MethodsThis multicentre, retrospective observational study involved 13 UK tertiary paediatric surgery centres. Children aged under 17 years, admitted between 1 October 2019 and 30 September 2020, following magnet, or BB ingestion were included. Demographics, investigations, management, and complications were recorded.ResultsIn total, 263 patients were identified, comprising 146 (55.5 per cent) magnet, 112 (42.6 per cent) BB, and 5 (1.9 per cent) mixed magnet BB ingestions. Median (interquartile range) age was 4.8 (2.0–9.1) years and 47.5 per cent were female. In the magnet group, 38 (26.0 per cent) children swallowed single magnets, 3 of whom underwent endoscopic retrieval for oesophageal or gastric impaction. Of the 108 (74.0 per cent) children who swallowed multiple magnets, 51 (47.2 per cent) required endoscopic or surgical intervention, predominantly for failure of magnets to progress on serial imaging. Bowel perforations occurred in 10 children (9.3 per cent). Younger age and ingestion of greater numbers of multiple magnets were independently associated with surgery. BB ingestion caused morbidity in 14 children (12.5 per cent) and life-threatening injuries in two (1.8 per cent); the majority were caused by oesophageal BBs (64.3 per cent).ConclusionMultiple magnet and BB ingestions are associated with significant morbidity. Action must be taken at an international level to regulate the sale of magnets and BBs, and to raise awareness of the risks that these objects pose to children.

Management of Tracheo-Bronchial Foreign Bodies in Children: Our Experience.

(1) To study the epidemiological profile of the patients. (2) To study the various modalities of investigations to arrive at confirmatory diagnosis. (3) To study the post-operative complications. It was a hospital based prospective study. A total of 36 paediatric patients were included in the study over a duration of 2years (August 2017 to July 2019). Written informed consent was taken from the parent of each patient before performing bronchoscopy. All the patients were subjected to careful clinical examination and investigations required followed by emergency bronchoscopic removal of foreign body. The patients were followed up at 1 and 3months after bronchoscopic removal. Amongst the 36 cases, 12 cases presented with airway emergency which addressed by bronchoscopic removal immediately. 10 cases presented with suggestive history of foreign body aspiration were subjected to clinical and radiological studies followed by bronchoscopic removal. 14 cases were referred from paediatric in-patient department who were being treated for unresolved LRTI. Early intervention is life saving if timely done. Unresolved LRTIs should be looked carefully to address missed foreign bodies. HRCT Thorax with 3-D reconstruction (Virtual Bronchoscopy) helps in exact localization of the foreign body. Experienced team of surgeons and anesthetist along with a ICU support is needed for efficient management.

Ingested Foreign Bodies Can Cause Appendicitis and Perforation: A Multi-Institutional Case Series.

Appendicular foreign bodies are a rare, under-described cause of appendicitis. We performed this study to determine the varied causes and consequences of foreign-body appendicitis. On retrospective review of the pathology archives of seven institutions, we identified 56 appendix specimens containing a foreign body (defined as ingested, non-digestible material). We recorded the type of foreign body, patient age and sex, and other findings, as available. Mean patient age was 7.7 years (range: 1 day-18 years). The foreign bodies included hair, plant material, magnets, other metallic material, BB pellets, foreign material not otherwise specified, and other miscellaneous objects. Of 48 cases with available clinical information, 31 patients presented with abdominal pain, and 22 were preoperatively diagnosed as having appendicitis/appendicular inflammation. Seven patients had appendiceal perforation (13%). The foreign body was grossly identified in 34/47 cases with available gross descriptions. Twenty-seven cases had an identifiable foreign body microscopically; 10 were associated with giant cell reaction. Hair and plant materials were the most common foreign objects found in the appendix; they often cause mucosal damage and giant cell reaction. Metallic objects were less common. Although appendicular foreign bodies in children are rare and sometimes asymptomatic, they may lead to perforation.

Vaginal foreign bodies in children: a single-center retrospective 10-year analysis.

To evaluate the clinical features and outcome in girls with a vaginal foreign body. The clinical data of 97 girls with a vaginal foreign body were collected between 2010 and 2020. The descriptive analysis was used to summarize the clinical characteristics. The patients were aged between 1.5 and 14.8years, and the age of peak incidence was shown to be 3-10years, which accounted for 88% of the cases. Blood-stained vaginal discharge or vaginal bleeding was the most common symptom (48%). The most common foreign bodies were small hard objects (57%), followed by bits of cloth or toilet tissue (22%). The patient whose foreign object was a disk battery had the most severe symptoms. When an injury of the vaginal mucosal was suspected, antibiotics were used to prevent infection, with full recovery of all patients without any additional treatment after removal of the foreign object. If there is no damage to the vaginal mucosa, no additional treatment is needed after the foreign body is removed. When a vaginal foreign body is suspected to be a battery, emergency surgery is needed to prevent further damage.

Failures in emergency management of pediatric airway foreign bodies by rigid bronchoscopy: we have yet to complete our learning

BackgroundSeveral children are affected by airway foreign body aspiration (FBA) resulting from life-threatening conditions. Choking has been considered the major symptom and is defined as airway blockage by a foreign...

Multiple gastrointestinal magnetic foreign bodies in children

Objective: To introduce the analysis of the clinical picture, treatment strategy and complications among children having multiple foreign magnetic bodies (FB).Methods: Retrospective analysis of the treatment of 796 children from 2013 to September 2021 having stomach and intestine FB. Comprehensive study included plan radiography of the abdomen, fiberoptic gastroduodenoscopy, etc.Results: Magnets were detected in 33 (4.15%) out of 796 cases. 9 patients swallowed multiple foreign magnetic bodies (FB) within time interval. The parts fixed in different parts of gastrointestinal tract (GIT) and required surgical removal. All patients had multiple perforations of different GIT parts. It required suturing gut wall, bowel resection applying gastrointestinal anasto mosis and celiogrhaphy, resection applying anastomosis and by leaving the programmed laparostomy. Every patient recovered. Algorithm of supervision of children having FB GIT.Conclusions: Multiple foreign magnetic bodies of GIT among children in the current moment are the most dangerous foreign objects accompanied with big amount of complications. They are observed among children of any age and gender and require complicated and long surgical interventions. Multiple foreign magnetic bodies of GIT can be suspected in case of severe surgical pathology along with the lack of passage of radiopaque FB in GIT. Urgent surgical intervention is required in case of detecting it.

Ear, Nose, and Throat Foreign Bodies in Children: A Retrospective Study.

Background: This study analyzed the presentation, characteristics, and management of foreign bodies in different age groups of pediatric patients with ear, nose, and throat foreign bodies. Methods: A retrospective study was performed using data from October 2012 to September 2020. A total of 1285 patients with ear, nose, and throat foreign bodies who were less than 12 years of age and who presented to the emergency room were included in this study. Their biographical data, clinical presentations, foreign body types and locations, and management outcomes were obtained from medical records and analyzed as three age groups (infancy: <2 years old; early childhood: 2–5 years old; and late childhood: 6–12 years old). Results: The early childhood group had the highest number of patients (n = 672; 52.2%). Throat was the most common location (59.2%), and bone was the most common type of foreign body. Among the children who visited our hospital, foreign bodies were actually found in only 657 patients (51.1%) and removed by an otolaryngologist in 625 (95.1%) cases. Conclusion: Our study could provide guidance for the diagnosis and management of pediatric patients who present to emergency departments with foreign bodies.

A "push-and-pull" trick for endoscopic removal of buckyballs impacted in the esophagus and gastric fundus.

As a common foreign body in children, magnet ingestion has been a widespread health issue. Unlike single magnet, ingestion of multiple magnets, especially those high-powered like Buckyballs could cause significant GI injury, e.g., perforation and fistula. Hereby we present a "push-and-pull" trick for management of a rare circumstance of Buckyballs ingestion.

A Retrospective Study of Oesophageal Foreign Bodies using Rigid Oesophagoscopy from Mandya, Karnataka, India

Introduction: Foreign bodies in the oesophagus is one of the commonly seen conditions in the Department of OItorhinolaryngology. Aim: To describe the clinical features and time delay of patients presenting with oesophageal foreign bodies. Materials and Methods: Present study was a retrospective study of case records of 60 patients who underwent rigid oesophagoscopy for foreign body removal at Mandya Institute of Medical Sciences Mandya, Karnataka, India, from January 2017 to December 2019. Details like age and sex of the patient, presenting symptoms, time delay in presentation to the hospital, the type of foreign body ingested, location of the foreign body in oesophagus, any complications were noted in a detailed case proforma. Preoperative X-ray of neck and chest was done in all patients. Descriptive statistical tests like percentage and mean were used to analyse the data. Results: Out of 60 patients, 36 (60%) were children and 24 (40%) patients were adults. Coin was the most common foreign body seen in children (n=32/60, i.e., 53.3%) whereas meat bone was the most common foreign body in adults (n=16/60, i.e., 26.6%). Forty two patients out of 60 presented within 24 hours of foreign body ingestion. Two patients presented after 72 hours of foreign body ingestion. Thirty one patients presented with foreign body sensation in throat, dysphagia was present in 21 patients and two patients presented with fever. Two patients who presented more than 72 hours after foreign body ingestion had mucosal oedema on rigid oesophagoscopy. There was mucosal injury in four patients intraoperatively, two were with dentures, one was with button battery and the other was with a sharp metal locket. Conclusion: Coin was the most commonly seen foreign body in children whereas meat bolus with or without bone was most commonly seen in adults. Timely diagnosis and early removal of the foreign body should be done to prevent complications.

Accidental ingestion of foreign bodies in children: a single center study.

Amaç: Çocukluk çağında sindirim sistemine ağız yoluyla kazara alınan yabancı cisimler önemli bir sağlık sorunudur. Çalışmamızda, tek merkezde kazara yabancı cisim yutma nedeni ile başvuran çocukları retrospektif olarak değerlendirip, karşılaşılan vakalarda durumu yönetme deneyimini göstermeyi amaçladık.&#x0D; Hastalar ve Yöntem: Karaman Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Kliniği’nce Mart 2016 ile Şubat 2021 tarihleri arasında yabancı cisim yutma nedeni ile hastalar yaş, cinsiyet, yabancı cismin cinsi, lokalizasyonu, radyolojik, ve klinik bulgular ile uygulanan tedavi açısından retrospektif olarak değerlendirildi. Hastaların parametreleri bilgisayar veri tabanından alındı. Eksik verilere sahip hastalar çalışma dışında tutuldu. &#x0D; Bulgular: Hastanemizde çalışma kriterlerine uygun kazara yabancı cisim yuttuğu tespit edilen 72 olgu incelendi. Eksik veriler nedeniyle biri dışlandı. Hastaların yaşları 6 ay ile 14 yaş arasında değişmekte olup 37 (% 51,4)’si 3 yaş ve altındadır. &#x0D; En sık yutulan yabancı cisim madeni paradır 35/72 (% 48,6), onu kalem pil 11/72 (%15,3), mıknatıs 6/72 (%8.3%) ve disk şeklinde pil 5/72 (% 7), 3 (%4.2) kırık cam, 3(%4.2) bilye, 2 (%2.8) kürdan,2 (%2.8) oyuncak parçası olduğu düşünülen plastik, 2 (%2.8) toplu iğne, 2(%2.8) vida, 1(%1.4) saç tokası izlemektedir. Sadece 10 (%13.9) hastada yutulan materyal radyografide görülmeyen radyolüsentti. Bunların büyük çoğunluğu 57/72(%79,1) gastrointestinal sistem ile dışarı atıldı. Kaza ile yutulan yabancı cisimlerden geriye kalan 9 (%12.5)’u Magill forseps,6(%8.3)’sı endoskopik olarak alındı. Hiçbir hasta eksploratif laparotomiye ihtiyacı olmadı.&#x0D; Sonuç: Madeni paranın yanlışlıkla yutulması, çocuklarda hala en yaygın yabancı cisimlerdir. Elektronik bir cihazda yaygın olarak kullanılan düğme pil giderek yaygınlaşmaktadır. Yabancı cisimlerin çoğu radyografi ile görselleştirilebilir ve vakaların çoğunda materyal herhangi bir müdahale olmaksızın kendiliğinden dışarı atılır. Hastaların erken teşhisi ve tedavisi, olası komplikasyon riskini azaltmak için önemlidir.

Overview on Gastrointestinal Foreign Bodies in Children

Introduction: Greatest percentage of the upper gastro intestinal accidently swallowed foreign bodies in adults are related to food bolus impaction with meat. Most patients who swallow a true foreign body typically are younger, however young children were recorded to accidently swallow other objects rather than food poluses. Males are more often recorded, and often have significant psychiatric illness and/or drug abuse. Foreign body (FB) ingestion is a very common problem in children. FB may pass through gastrointestinal (GI) system silently without any indication, or it may need an intervention to prevent complications. The diagnosis, decision for involvement and management may have some difficulties, and it’s usually decided according to the case, especially in cases with protracted lodgment. Complications caused by lodgment of ingested GI FBs varies according to many factors and are associated with important morbidity and mortality in children.&#x0D; Objectives: to show an overview of gastrointestinal foreign bodies in children, its epidemiology, risk factors, hazards and management.

Abnormal calcification misdiagnosed as esophageal foreign body in children: report of two cases

食道异物是儿童急症的常见疾病之一。儿童食道异物多为硬币等金属异物或动物骨骼等骨性异物，而临近组织的异常钙化较易误诊为外源性的食道异物。本文报告了儿童茎突舌骨韧带和杓状软骨的异常钙化误诊为食道异物的2例病例，通过对儿童食道异物病史及影像学资料进行分析并复习相关文献，总结其误诊原因及诊治特点，有助于降低儿童食道异物的误诊率。.