J Korean Assoc Pediatr Surg.  2014 Jun;20(1):12-16.

Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

• Choi E
• Lee HG
• Choi SJ
• Chung SY

Abstract

Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.

Keyword

Foreign body; Gastrointestinal tract; Children

MeSH Terms

Abdomen
Child*
Eating
Emergencies
Endoscopy
Foreign Bodies*
Gastrointestinal Tract*
Humans
Jeollanam-do
Medical Records
Retrospective Studies

Figure

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  Fig. 1. Schematic review of management and results of foreign bodies ingested patients. ER: emergency room, EGD: esophagogastroduodenoscopy, F/U: follow up.

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  Fig. 2. (A) Impaction of foreign body in appendix (gold accessory). (B) Impaction of foreign body in small intestine (hair pin).

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  Fig. 3. (A) Perforation of duodenal second portion by hair pin. (B) Perforation of gastric greater curvature and jejunum by two magnets.

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