Abstract
A retrospective study was performed to determine the predisposing factors associated with the complications of ingested gastrointestinal (GI) tract foreign bodies (FBs) in children who had surgical or endoscopic removal. The study was performed in 161 children who had endoscopic or surgical removal. The clinical data were evaluated in two groups. In groups I and II, respectively, 135 patients with no complications and 26 patients with complications were analyzed. The relative risk analysis was performed for the risk factors. The number of the patients with an accurate history and the radiopaque FBs was significantly higher in group I. Metal, especially sharp objects, and food plugs obstructing a diseased esophagus were the most common FBs found in group II. The majority of the FBs of both groups were entrapped in esophagus, the number of the FBs distal to esophagus was significantly higher and duration of lodgment was significantly longer in group II. Esophageal abrasion, laceration and bleeding, complete esophageal obstruction, caustic injury, severe esophageal stricture, laryngeal edema, recurrent aspiration pneumonia, loss of weight, intestinal perforation, constipation and intestinal obstruction were determined as complications. The relative risk was >1 for duration of lodgment more than 24 h, for sharp or pointed objects, button batteries, nonopaque objects, diseased esophagus and for the objects located below the upper third of esophagus. Type, radiopacity, location and duration of the ingested GI tract FB determine the outcome. A delayed diagnosis is the most significant factor increasing the risk of complications. Physician must maintain a high index of suspicion and a more extensive history; physical examination and radiodiagnostic investigation should be obtained in suspected cases.
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References
Stack LB, Munter DW (1996) Foreign bodies in the gastrointestinal tract. Emerg Med Clin N Am 14:493–521
Samad L, Ali M, Ramzi H (1999) Button battery ingestion: hazards of esophageal impaction. J Pediatr Surg 34:1527–1531
Tucker JG, Kim HH, Lucas GW (1994) Esophageal perforation caused by coin ingestion. South Med J 87:269–272
Messner AH (1998) Pitfalls in the diagnosis of aerodigestive tract foreign bodies. Clin Pediatr 37:359–365
Papsin BC, Friedberg J (1994) Aerodigestive tract foreign bodies in children: pitfalls in management. J Otol 23:102–108
Louie JP, Alpern ER, Windreich RM (2005) Witnessed and unwitnessed esophageal foreign bodies in children. Pediatr Emerg Care 21:582–585
Woolley SL, Smith DR (2005) History of possible foreign body ingestion in children: don’t forget the rarities. Eur J Emerg Med 12:312–316
Arana A, Hauser B, Hachimi-Idrissi S et al (2001) Management of ingested foreign bodies in childhood and review of the literature. Eur J Pediatr 160:468–472
Seo JK (1999) Endoscopic management of gastrointestinal foreign bodies in children. Indian J Pediatr 66 (1 Suppl):s75–s80
Doolin EJ (1993) Esophageal stricture: an uncommon complication of foreign bodies. Ann Otol Rhinol Laryngol 102:863–866
Pinero Madrona A, Fernandez Hernandez JA, Carrasco Prats M et al (2000) Intestinal perforation by foreign bodies. Eur J Surg 166:307–309
Litovitz T, Schmitz BF (1992) Ingestion of cylindrical and button batteries: an analysis of 2382 cases. Pediatrics 89:747–757
Healy GB (1991) Aerodigestive tract foreign bodies. In: Fallis JC, Filler RM, Lemoine G (eds) Pediatric thoracic surgery. Elsevier, New York, pp 192–200
Crysdale WS, Sendi KS, Yoo J (1991) Esophageal foreign bodies in children: 15-year review of 484 cases. Ann Otol Rhinol Laryngol 100:320–324
Newman B, Girdany BR (1990) Gastric trichobezoars—sonographic and computed tomographic appearance. Pediatr Radiol 20:526–527
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Tokar, B., Cevik, A.A. & Ilhan, H. Ingested gastrointestinal foreign bodies: predisposing factors for complications in children having surgical or endoscopic removal. Pediatr Surg Int 23, 135–139 (2007). https://doi.org/10.1007/s00383-006-1819-0
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DOI: https://doi.org/10.1007/s00383-006-1819-0