Foreign body ingestion in children: unusual presentations and timely intervention

Abstract

Background/purpose: Foreign body (FB) ingestion in children is very common. Children can ingest a wide variety of FBs. Most of the ingested FBs pass spontaneously through the gastrointestinal tract. Other FBs, especially uncommonly ingested objects, can present with complications and need intervention to be extracted. The aim of this study was to highlight the importance of timely intervention to extract these FBs.

Patients and methods: Between November 2012 and October 2017, patients who presented to our department with variously ingested FBs were retrospectively reviewed to detect those who needed intervention (surgical or endoscopic) to extract these FBs.

Results: During the specified time period, 480 patients with FB ingestion presented to our department. Out of these children, 12 patients ingested uncommon FBs or presented with symptoms of complications of impaction and needed intervention to extract these FBs. Three patients ingested multiple magnets. Three patients ingested pins which were impacted in and penetrated the duodenum. One patient ingested a screw which was impacted in the appendix. One patient ingested a sticky rubber toy which was impacted in the pylorus. One patient ingested hair (bezoar), which was also impacted in the pylorus. One patient ingested a disk battery which was impacted in and penetrated the esophagus, and all were surgically extracted. One patient had a slipped stent of repaired choanal atresia which was impacted in the gastroesophageal junction and one patient with repaired tracheoesophageal fistula ingested a stone which was impacted at the site of esophageal anastomosis, and both were endoscopically retrieved.

Conclusion: Children who ingested uncommon FBs or presented late with symptoms of complications of impaction needed intervention (surgically or endoscopically) to extract these FBs.

Keywords: foreign bodies, foreign body extraction, ingestion, magnets ingestion, pin ingestion