Children Will Eat the Strangest Things
- 1 August 2012
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pediatric Emergency Care
- Vol. 28 (8), 731-734
- https://doi.org/10.1097/pec.0b013e31826248eb
Abstract
Foreign body (FB) ingestions are common in children presenting to the emergency department. Health care providers are quickly challenged to determine which children need urgent endoscopy for diagnostic or therapeutic reasons. We performed a retrospective study to determine if esophageal injury caused by FB ingestion correlated to presenting signs or symptoms, location of impaction, duration of impaction, or denomination of coin (as this was the most commonly ingested FB). A retrospective chart review of children between birth and 17 years of age who presented for esophagogastroduodenoscopy for removal of upper gastrointestinal FB was performed. Demographic data collected from all children included age, sex, and race. For children with FB ingestion, the type of FB, location of the FB, underlying gastrointestinal pathology, duration of impaction, and endoscopic findings were recorded. Descriptive analysis of the data was performed using means, medians, SD, and percentages; χ2 test was used to test the association between categorical variables. Over a 10-year period of review, a total of 3279 esophagogastroduodenoscopies were performed; 248 (7.8%) were done for FB removal. The mean age for children having endoscopy for FB removal was 3.9 (SD, 3.2) years (median, 3.1 years); there was a slight male predominance (male/female ratio = 1.6:1). The vast majority (81%) of retained FBs was coins. Most of the FBs were located in the upper esophagus (68%). Success rate for retrieval was greater for esophageal FBs (99%) than for more distally located FBs (70%; P Conclusions Ingestion of FBs by children remains a significant problem faced by emergency department personnel. In our study, a complaint of substernal chest pain in children with an esophageal FB predicted esophageal ulceration. Also, esophageal FBs unexpectedly found on chest radiograph or known to be present greater than 72 hours were more likely to have esophageal ulceration. These clinical and historic clues can help direct appropriate prompt referral for endoscopic removal.Keywords
This publication has 17 references indexed in Scilit:
- Foreign body ingestion: children like to put objects in their mouthWorld Journal of Pediatrics, 2010
- Endoscopic Removal of Foreign Bodies in ChildrenThe Kaohsiung Journal of Medical Sciences, 2007
- Esophageal foreign bodies in the pediatric population: our first 500 casesJournal of Pediatric Surgery, 2006
- Removal of a Foreign Body from the Upper Gastrointestinal Tract with a Flexible Endoscope: a Prospective StudyEndoscopy, 2004
- Chronic esophageal foreign bodies in pediatric patients: a retrospective reviewInternational Journal of Pediatric Otorhinolaryngology, 2004
- Foreign bodies in the aerodigestive tract in pediatric patientsAuris Nasus Larynx, 2003
- Esophageal foreign bodies: a Jordanian experienceInternational Journal of Pediatric Otorhinolaryngology, 2002
- Esophageal foreign bodiesEuropean Journal of Cardio-Thoracic Surgery, 1998
- Management of foreign bodies of the upper gastrointestinal tract: UpdateGastrointestinal Endoscopy, 1995
- Toothbrush SwallowingArchives of Surgery, 1988