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Kasakanga K, Groenewald A, Mabitsela ME, Tshifularo N. A Retrospective Review of the Management of Impacted Coin Ingested in Children. Afr J Paediatr Surg 2024:01434821-990000000-00018. [PMID: 39254056 DOI: 10.4103/ajps.ajps_114_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/26/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Accidental coin ingestion is a common presentation amongst paediatric patients in emergency departments (ED) worldwide, necessitating prompt management to prevent complications. OBJECTIVES This study aimed to describe the clinical features of paediatric patients with impacted oesophageal coins at Dr. George Mukhari Academic Hospital ED and compare outcomes between the balloon catheter and oesophagoscopic techniques for coin extraction. METHODS This was a retrospective review of the medical records of patients aged ≤12 years over 5 years. Data were collected from the hospital records and analysed using SAS® (SAS Institute Inc, Cary, NC), Release 9.3, running under Microsoft Windows. RESULTS The analysis included 95 patients (51 females, 44 males) with a median age of 3 years, ranging from 0.70 to 10 years. Coins were predominantly located in the upper oesophagus (71.6%). Thirty-five (36%) children presented 8 h after the ingestion of the coin. At presentation, 82 (86.3%) patients were asymptomatic. The most observed symptoms were hypersalivation in 17 (17.9%) patients and vomiting in eight (8.4%) patients. Of the 62 patients for whom the balloon catheter was solely used, it was successful in 77.4% of the cases. Rigid oesophagoscopy was used in 33 patients as the first procedure (34.7%), and its overall success rate was 100% (44 patients). CONCLUSIONS This study contributes valuable insights into the management of oesophageal coin ingestion in a resource-constrained setting, emphasising the safety and efficacy of the balloon catheter and the role of rigid oesophagoscopy in cases of failure or delayed presentation.
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Affiliation(s)
- Kmj Kasakanga
- Department of Pediatric Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - A Groenewald
- Emergency Division of Family Medicine Department, Wits University, Johannesburg, Gauteng, South Africa
| | - M E Mabitsela
- Department of General Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - N Tshifularo
- Department of Pediatric Surgery, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Foreign body ingestion and associated factors in pediatric patients at a tertiary care center. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2021; 87:20-28. [PMID: 34635446 DOI: 10.1016/j.rgmxen.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION AND AIMS Foreign body (FB) ingestion is a common problem in children under 5 years of age and is one of the main indications for endoscopy. The aim of the present study was to describe the clinical, radiographic, and endoscopic characteristics of patients with FB ingestion, as well as the factors associated with the anatomic location and the type of object ingested. MATERIALS AND METHODS An analytic cross-sectional study was conducted on all patients with FB ingestion seen at the gastroenterology service from January 2013 to December 2018. The data were analyzed using the SPSS program, obtaining frequencies, percentages, medians, and interquartile ranges. Associations were assessed through the chi-square test. RESULTS Eighty-five patients (52 males and 33 females) were included, with a median age of 4 years. The most common symptom was vomiting (29.4%). Two radiographic projections were carried out in 72.9% of the cases and the stomach was the site where the FB was most frequently visualized (32.9%). The objects most commonly ingested were coins (36%), with esophageal location (p<0.05), as well as objects with a diameter larger than 2cm (p<0.05). An endoscopic procedure was performed on 76 patients (89.4%) for FB extraction, with findings of erythema (28.9%), erosion (48.6%), ulcer (10.5%) and perforation (1.3%). CONCLUSIONS Numerous factors should be taken into account in the approach to FB ingestion in pediatric patients, including type and size of the FB, time interval from ingestion to hospital arrival, and patient clinical status and age.
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Navia-López LA, Cadena-León JF, Ignorosa-Arellano KR, E M Toro-Monjaraz, Zárate-Mondragón F, Loredo-Mayer A, Cervantes-Bustamante R, Ramírez-Mayans JA. Foreign body ingestion and associated factors in pediatric patients at a tertiary care center. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2021; 87:S0375-0906(21)00032-X. [PMID: 33892985 DOI: 10.1016/j.rgmx.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 09/09/2020] [Accepted: 09/16/2020] [Indexed: 10/21/2022]
Abstract
INTRODUCTION AND AIMS Foreign body (FB) ingestion is a common problem in children under 5 years of age and is one of the main indications for endoscopy. The aim of the present study was to describe the clinical, radiographic, and endoscopic characteristics of patients with FB ingestion, as well as the factors associated with the anatomic location and the type of object ingested. MATERIALS AND METHODS An analytic cross-sectional study was conducted on all patients with FB ingestion seen at the gastroenterology service from January 2013 to December 2018. The data were analyzed using the SPSS program, obtaining frequencies, percentages, medians, and interquartile ranges. Associations were assessed through the chi-square test. RESULTS Eighty-five patients (52 males and 33 females) were included, with a median age of 4 years. The most common symptom was vomiting (29.4%). Two radiographic projections were carried out in 72.9% of the cases and the stomach was the site where the FB was most frequently visualized (32.9%). The objects most commonly ingested were coins (36%), with esophageal location (p <0.05), as well as objects with a diameter larger than 2cm (p <0.05). An endoscopic procedure was performed on 76 patients (89.4%) for FB extraction, with findings of erythema (28.9%), erosion (48.6%), ulcer (10.5%) and perforation (1.3%). CONCLUSIONS Numerous factors should be taken into account in the approach to FB ingestion in pediatric patients, including type and size of the FB, time interval from ingestion to hospital arrival, and patient clinical status and age.
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Affiliation(s)
- L A Navia-López
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México.
| | - J F Cadena-León
- Departamento de Gastroenterología y Nutrición Pediátrica, Unidad de Diagnóstico en Gastroenterología Pediátrica Integral (UDIGAPI), Instituto Nacional de Pediatría, Ciudad de México, México
| | - K R Ignorosa-Arellano
- Departamento de Gastroenterología y Nutrición Pediátrica, Unidad de Diagnóstico en Gastroenterología Pediátrica Integral (UDIGAPI), Instituto Nacional de Pediatría, Ciudad de México, México
| | - E M Toro-Monjaraz
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - F Zárate-Mondragón
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - A Loredo-Mayer
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - R Cervantes-Bustamante
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
| | - J A Ramírez-Mayans
- Servicio de Gastroenterología y Nutrición, Instituto Nacional de Pediatría, Ciudad de México, México
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Varik R, Shubha AM, Das K. Multiple Atypical Esophageal Foreign Bodies in an Infant. J Indian Assoc Pediatr Surg 2020; 25:242-244. [PMID: 32939118 PMCID: PMC7478286 DOI: 10.4103/jiaps.jiaps_101_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/13/2019] [Accepted: 10/26/2019] [Indexed: 11/30/2022] Open
Abstract
Foreign body ingestion is a common accidental emergency in children. We report an unusual case of multiple blunt and sharp esophageal foreign bodies in a female infant probably associated with homicidal intent and its management.
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Affiliation(s)
- Roma Varik
- Department of Paediatric Surgery, St. John's Medical College Hospital, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Attibele Mahadevaiah Shubha
- Department of Paediatric Surgery, St. John's Medical College Hospital, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Kanishka Das
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Endoscopic management of foreign body ingestion in children. GASTROENTEROLOGY REVIEW 2020; 15:349-353. [PMID: 33777276 PMCID: PMC7988830 DOI: 10.5114/pg.2020.101563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/29/2019] [Indexed: 11/17/2022]
Abstract
Introduction Foreign body ingestion is common in children. Most accidental ingestions are passed spontaneously without intervention. Some cases of ingestion require intervention in a timely fashion to reduce risks and morbidities. Aim To analyse the clinical presentation, aetiology, and outcome of children presenting with foreign body ingestion, who required endoscopic intervention at a tertiary hospital (King Abdullah University Hospital, Irbid, Jordan). Material and methods Records of all patients with ingested foreign bodies requiring endoscopic retrieval over a 3-year period were reviewed retrospectively. Data on age, sex, type of ingested foreign body, presentation, type of intervention, stuck and retrieval location, outcome, and complications were collected. Results Of the sixty-three patients identified, 32 (50.8%) were male. Mean patient age was 7.7 ±3.4 years (range: 1 month-17.4 years). Most patients (74.6%) presented asymptomatically after the family or the child reported ingestion. Coins were the most commonly retrieved foreign bodies (37, 58.7%). The oesophagus was the most common site of retrieval (45, 71%). A rat tooth forceps was most commonly used to retrieve coins, followed by a net basket. Endoscopy was effective in managing the foreign body in 57 (90.5%) cases. Surgery was needed in 1 (1.6%) patient, a 1-month-old infant with a plastic tube in his stomach. All patients tolerated the procedure well with no complications. Interestingly, 7 (11.1%) male patients showed endoscopic features of eosinophilic oesophagitis; eosinophilic oesophagitis was confirmed histopathologically in three of them. Conclusions Endoscopic intervention is effective and well tolerated in the management of ingested foreign bodies in the upper gastrointestinal system. Parents and children should be cautioned against playing with coins, to reduce the incidence of foreign body ingestion.
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Xiong Y, Yu J, Luo Q, Jiang H, Zhang J. Novel Bougie for the Management of Esophageal Coins in Children: An Observational Study. Ann Otol Rhinol Laryngol 2019; 128:503-507. [PMID: 30758230 DOI: 10.1177/0003489419828764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine the efficacy and safety of a novel bougie for the removal of esophageal coins lodged in the proximal esophagus. SUBJECTS AND METHODS This was an observational study. Medical records were reviewed of patients who were confirmed with esophageal coins between July 2015 and October 2016 in our department. Sixty-three patients, upper esophageal coins were confirmed by radiographs, were treated by using this novel bougie to remove esophageal coins. RESULTS A total of 63 children were enrolled in this study. Sixty coins (95%) were removed successfully. The coin was extracted on the first attempt in 56 cases (89%), the second attempt in 3 cases (5%), and the third attempt in 1 case (2%). Two coins retained in the esophagus underwent endoscopy. In the remaining patient, the coin passed into the stomach and was confirmed to be passed in the stool within 48 hours. No serious complications occurred in any subject. CONCLUSIONS Our novel bougie procedure is likely a safe, highly efficient approach to managing esophageal coins given that no serious complications of the 63 patients were reported. This simple technique may provide another valuable option to physicians.
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Affiliation(s)
- Yuanping Xiong
- 1 First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jieqing Yu
- 1 First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qing Luo
- 1 First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hongqun Jiang
- 1 First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jian Zhang
- 1 First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Al Lawati TT, Al Marhoobi R. Patterns and Complications of Ingested Foreign Bodies in Omani Children. Oman Med J 2018; 33:463-467. [PMID: 30410687 DOI: 10.5001/omj.2018.86] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objectives We sought to describe the frequency of encounters and complications of foreign body (FB) ingestion in children seen at Royal Hospital, Oman. Methods Medical records of all children (≤ 13 years) who presented to Royal Hospital between 1 January 2011 and 31 December 2014 diagnosed with FB ingestion were reviewed. Children with FBs in their mouth or airway, with esophageal food impaction, and caustic ingestion were excluded from the analysis. Parameters including age, sex, type of FB, anatomical location of the FB on X-ray, endoscopic findings, and all complications were reviewed. Results Of the 585 children diagnosed with FB ingestion, 385 were included in the study; 58.4% were males and 41.6% were females giving a male to female ratio of 1.4:1.0. Half (50.9%) of the children were less than three years old. Coins were the most frequently ingested objects (41.3%) followed by disc batteries (12.2%). Sixty-three patients (16.3%) required urgent esophagogastroduodenoscopy (EGD). EGD was performed mainly for coins (44.4%) followed by disc batteries (14.3%) in the esophagus or stomach. The complication rate was 5.2% in total, and 3.6% for clinically significant complications. We had no mortality cases. Conclusions FB ingestion is common in toddlers in Oman. Coins and disc batteries are most commonly ingested calling for strict family vigilance. Endoscopy is done in a small number of children and clinically significant complications, in general, are low. However, these findings should not lead to a false sense of security, and ingested FBs should always be taken seriously.
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Affiliation(s)
- Tawfiq Taki Al Lawati
- Department of Child Health, Division of Pediatric Gastroenterology, Royal Hospital, Muscat, Oman
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Tang LJ, Zhao H, Lou JG, Peng KR, Yu JD, Luo YY, Fang YH, Chen FB, Chen J. [Clinical features and prognosis of gastrointestinal injury due to foreign bodies in the upper gastrointestinal tract in children: a retrospective analysis of 217 cases]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2018; 20:567-571. [PMID: 30022760 PMCID: PMC7389193 DOI: 10.7499/j.issn.1008-8830.2018.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 05/24/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To study the clinical features and prognosis of gastrointestinal injury caused by foreign bodies in the upper gastrointestinal tract in children. METHODS A retrospective analysis was performed for the clinical data of 217 children who were diagnosed with foreign bodies in the upper gastrointestinal tract complicated by gastrointestinal injury by gastroscopy from January 2011 to December 2016, including clinical features, gastroscopic findings, complications, and prognosis. RESULTS Among the 217 children, 114 (52.5%) were aged 1-3 years. The most common foreign body was coin (99/217, 45.6%), followed by hard/sharp-edged food (45/217, 20.7%) and metal (35/217, 16.1%). The most common gastrointestinal mucosal injury was ulceration (43.8%), followed by erosion (33.2%). Compared with other foreign bodies, button cells were significantly more likely to cause esophageal perforation (P<0.01). The esophagus was the most commonly injured organ (207/217, 95.4%). Of all the 217 children, 24 (11.1%) experienced infection. The children with perforation caused by foreign bodies had a significantly higher incidence rate of infection than those with ulceration caused by foreign bodies (P=0.003). Of all the 217 children, 204 (94.0%) underwent successful endoscopic removal of foreign bodies. Among these children, 98 were hospitalized due to severe mucosal injury and were given anti-infective therapy, antacids, and supportive care including enteral nutrition through a nasogastric tube and/or parenteral nutrition. Of all the children, 10 left the hospital and were lost to follow-up, and all the other children were improved and discharged. CONCLUSIONS Most cases of foreign bodies in the upper gastrointestinal tract occur at 1-3 years of age. Coin, hard/sharp-edged food, and metal are the most common foreign bodies. Button cells are more likely to cause esophageal perforation. The incidence rate of secondary infection increases with the increasing severity of gastrointestinal mucosal injury. Children undergoing endoscopic removal of foreign bodies and enteral nutrition through a nasogastric tube tend to have a good prognosis.
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Affiliation(s)
- Lu-Jing Tang
- Department of Gastroenterology, Children's Hospital of Zhejiang University School of Medicine, Hangzhou 310003, China.
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Yeh HY, Chao HC, Chen SY, Chen CC, Lai MW. Analysis of Radiopaque Gastrointestinal Foreign Bodies Expelled by Spontaneous Passage in Children: A 15-Year Single-Center Study. Front Pediatr 2018; 6:172. [PMID: 29946536 PMCID: PMC6006757 DOI: 10.3389/fped.2018.00172] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Most ingested foreign bodies (FBs) pass spontaneously through the gastrointestinal (GI) tract, but only limited data on transit time are available. We evaluated the relationship of FB size and shape with transit time. Methods: We retrospectively reviewed medical records collected over 15 years (January 2001 to December 2015) on pediatric patients with radiopaque FBs in the GI tract. We categorized the FBs as regularly (round or spherical) or irregularly shaped (ovoid, long, flake-like, or projecting) and measured their sizes radiographically. The diameter of regularly shaped FBs and the length of irregularly shaped FBs were correlated with transit time. Results: In total, 484 patients with GI FBs were surveyed, and 267 (55.1%) FBs were radiopaque. Among the 267 radiopaque FBs, 88 (33.1%) required endoscopic removal and 7 (2.6%) underwent surgical intervention. Eighty-seven patients with single FBs in the GI tract for whom precise details of transit time were enrolled into the analysis of transit time; their mean age was 3.48 ± 2.21 years. Of the 87 FBs, 61 (70.1%) were regularly shaped, and 26 (29.9%) were irregularly shaped. The diameter of regularly shaped FBs was positively associated with transit time, as revealed by Mann-Whitney U test; diameters >1.5 and >2 cm were significantly correlated with longer transit times (both p = 0.003). A trend toward an increased transit time for long irregularly shaped FBs was also apparent; the p-values for lengths of 1.5, 2, and 2.5 cm were 0.824, 0.153, and 0.055, respectively. Under receiver operating characteristic (ROC) curve analysis, the optimal cutoff diameter for regularly shaped FBs, and length for irregularly shaped FBs, to predict a transit time of longer than 72 h were 1.95 and 2.25 cm, respectively. Conclusions: The passage rate of ingested radiopaque FBs is 64.4%. Small FBs that have passed the duodenal curve should be managed conservatively via clinical observation and radiographic surveillance. Our results indicate that the larger an FB is, the longer the transit time will be.
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Affiliation(s)
- Hung-Yu Yeh
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsun-Chin Chao
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Yen Chen
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Chang Chen
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Wei Lai
- Division of Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Ramareddy RS, Alladi A. Review of esophageal injuries and stenosis: Lessons learn and current concepts of management. J Indian Assoc Pediatr Surg 2016; 21:139-43. [PMID: 27365909 PMCID: PMC4895740 DOI: 10.4103/0971-9261.182589] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: To review the patients with esophageal injuries and stenosis with respect to their etiology, clinical course, management, and the lessons learnt from these. Materials and Methods: Retrospective descriptive observation review of children with esophageal injuries and stenosis admitted between January 2009 and April 2015. Results: Eighteen children with esophageal injuries of varied etiology were managed and included, seven with corrosive injury, five with perforation due to various causes, three with mucosal erosion, two with trachea esophageal fistula (TEF), and one wall erosion. The five children who had perforation were due to poststricture dilatation in a child with esophageal atresia and secondary to foreign body impaction or its attempted retrieval in four. Alkaline button cell had caused TEF in two. Three congenital esophageal stenosis (CES) had presented with dysphagia and respiratory tract infection. Six corrosive stricture and two CES responded to dilatation alone and one each of them required surgery. Four of the children with esophageal perforation were detected early and required drainage procedure (1), diversion (1), and medical management (2). Pseudo diverticulum was managed expectantly. Among TEF, one had spontaneous closure and other one was lost to follow-up. All the remaining nineteen children have recovered well except one CES had mortality. Conclusion: Esophageal injuries though rare can be potentially devastating and life-threatening.
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Affiliation(s)
- Raghu Sampalli Ramareddy
- Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Anand Alladi
- Department of Pediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
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PASSALI D, GREGORI D, LORENZONI G, COCCA S, LOGLISCI M, PASSALI F, BELLUSSI L. Foreign body injuries in children: a review. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2015; 35:265-71. [PMID: 26824213 PMCID: PMC4731891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of this paper was to overview existing knowledge on foreign body (FB) injuries in children, with particular focus on FB types and anatomical locations, clinical presentation and complications. FB injuries represent a severe public health problem in childhood. The fact that the highest prevalence of FB injuries is reported for children between 0 and 3 years of age depends primarily on the fact that they explore objects using their mouth and are also not able to distinguish edible objects from non-edible ones. Types of FB causing injuries depend on the symptoms related to FB ingestion/inhalation/insertion (providing an early diagnosis of FB injuries) and complications related to the FB characteristics (type, shape, dimensions). The analysis of the Susy Safe database showed that in 10,564 cases, in which the object type was available, 74% of objects were inorganic and were mostly represented by pearls and balls, followed by coins. The main concerning about FB injuries is the fact that they may be asymptomatic or that symptoms may be non-specific. Consequently, the FB injury can be misinterpreted as a gastrointestinal or respiratory infection. The absence of specific symptoms indicating the occurrence of FB injury can lead to delays in diagnosis, thereby increasing the risk of complications. Symptoms seem to mostly depend on the anatomical location. Many ingested FBs pass naturally through the gastrointestinal tract without complications or damage. However, severe complications can occur depending on the characteristics of the FB, its anatomical location, the child's age and delays in diagnosis.
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Affiliation(s)
- D. PASSALI
- ENT Clinic University of Siena, Italy;,Address for correspondence: Desiderio Passali, ENT Clinic University of Siena, viale Bracci 33, 53100 Siena Italy. E-mail:
| | - D. GREGORI
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - G. LORENZONI
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy
| | - S. COCCA
- ENT Clinic University of Siena, Italy
| | | | - F.M. PASSALI
- ENT Clinic Università di Roma Tor Vergata, Rome, Italy
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Joyamaha D, Conners GP. Managing Pediatric Foreign Body Ingestions. MISSOURI MEDICINE 2015; 112:181-6. [PMID: 26168587 PMCID: PMC6170127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Foreign body ingestion is common among children. A variety of foreign bodies are ingested, most of which are harmless and pass spontaneously through the gastrointestinal (GI) tract. There are a few particularly harmful and life threatening objects that should be identified and removed immediately to avoid serious complications.
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Pecorari G, Tavormina P, Riva G, Landolfo V, Raimondo L, Garzaro M. Ear, nose and throat foreign bodies: the experience of the Pediatric Hospital of Turin. J Paediatr Child Health 2014; 50:978-84. [PMID: 24945078 DOI: 10.1111/jpc.12673] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 11/28/2022]
Abstract
AIM Ear, nose and throat (ENT) foreign body (FB) injuries represent an emerging problem in the paediatric population because of their human and social costs. The aim of the study is the site-specific evaluation of FB injuries in the paediatric population referred to the emergency department of the Pediatric Hospital of Turin. METHODS This retrospective analysis was carried out sifting medical reports between 2002 and 2011. We collected information about 338 patients' FB characteristics, complications and hospitalisation. RESULTS The mean age was 4.2 ± 2.9 years. Nose and ear are the most involved anatomical sites, followed by pharynx, oesophagus and trachea-bronchi. The most common FBs are balls, beads and toys parts (29.6%), followed by fishbones (13.6%). A lower mean age is observed in tracheo-bronchial and oesophageal FBs. The 9.2% of cases reported complications. CONCLUSIONS A quick and proper diagnosis followed by an effective treatment of FB injuries and their complication is mandatory. Surveillance registries have a key role in prevention and management of FB injuries; useful information can be obtained also for nurse and ENT specialist training in order to create professionals ready to recognise and manage FB injuries in the most effective way.
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Affiliation(s)
- Giancarlo Pecorari
- Surgical Sciences Department, University of Turin, 1st ENT Division, Turin, Italy
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Yan XE, Zhou LY, Lin SR, Wang Y, Wang YC. Therapeutic effect of esophageal foreign body extraction management: flexible versus rigid endoscopy in 216 adults of Beijing. Med Sci Monit 2014; 20:2054-60. [PMID: 25349897 PMCID: PMC4214697 DOI: 10.12659/msm.889758] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background The aim of this study was to assess the effectiveness and complications of rigid endoscopy (RE) and flexible endoscopy (FE) for the extraction of esophageal foreign bodies (FB) in adults. Material/Methods A retrospective analysis was conducted on the medical records of 216 adult patients with esophageal FB impaction treated at Peking University Third Hospital, Beijing, China, between January 2008 and December 2012. Results The success rate of FB extraction was 100% (142/142) in patients treated with RE compared to 97.3% (72/74) in those treated with FE (P=0.045). The total incidence of complications in RE-treated patients was lower than that in FE-treated patients (28.2% vs. 45.9%, P=0.009), but the perforation rate was higher (5.6% vs. 1.4%, P=0.135). The incidences of total complications and perforation were associated with the duration of FB impaction in patients who underwent RE (both P<0.05) but not in patients who underwent FE. RE was more frequently used in extraction of FBs located in the upper esophagus (88.7%, 126/142) compared to FE (60.8%, 45/74) (P<0.05). The size of extracted FB was significantly larger in patients treated with FE compared to those treated with RE (P<0.05). Conclusions Both RE and FE were effective in the extraction of esophageal FB. However, the perforation rate and the need for general anesthesia were higher in RE-associated extraction. FE may be the preferred endoscopic treatment for the extraction of esophageal FB, except possibly for those impacted in the upper esophagus. FB extraction may produce better outcomes if endoscopy is employed early.
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Affiliation(s)
- Xiu-e Yan
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China (mainland)
| | - Li-ya Zhou
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China (mainland)
| | - San-ren Lin
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China (mainland)
| | - Ye Wang
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China (mainland)
| | - Ying-chun Wang
- Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China (mainland)
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16
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Abstract
Although most ingested foreign bodies in children pass spontaneously, certain foreign bodies can be harmful and they require special attention and emergent medical intervention to prevent significant morbidity and mortality. This article presents an overview of the epidemiology, diagnosis, management, and complications of foreign body ingestions in children. Particular attention is paid to coins, sharp objects, long objects, food bolus, caustic liquids, batteries, and magnets.
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Affiliation(s)
- Christian C Wright
- Division of Emergency Medicine, Department of Pediatrics, University of Maryland School of Medicine, University of Maryland Children's Hospital, 22 South Greene Street, Baltimore, MD 21201, USA.
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17
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Li QP, Ge XX, Ji GZ, Fan ZN, Zhang FM, Wang Y, Miao L. Endoscopic retrieval of 28 foreign bodies in a 100-year-old female after attempted suicide. World J Gastroenterol 2013; 19:4091-4093. [PMID: 23840158 PMCID: PMC3703200 DOI: 10.3748/wjg.v19.i25.4091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 03/31/2013] [Accepted: 05/18/2013] [Indexed: 02/06/2023] Open
Abstract
Foreign body ingestion is a common emergency situation in children with one or a few objects having been ingested. Here we report our experience using endoscopic retrieval in a female centenarian with dyspnea and foreign bodies in the esophagus. She attempted suicide by swallowing 26 coins and two other foreign bodies. A gastroscope was used to remove all foreign bodies in the lower esophagus. In total, 26 coins, one ferrous ring and one cylindrical plastic object were retrieved. To our knowledge, this is the first clinical report on retrieval of so many foreign bodies in a single case.
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18
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Chauvin A, Viala J, Marteau P, Hermann P, Dray X. Management and endoscopic techniques for digestive foreign body and food bolus impaction. Dig Liver Dis 2013; 45:529-42. [PMID: 23266207 DOI: 10.1016/j.dld.2012.11.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Accepted: 11/02/2012] [Indexed: 02/07/2023]
Abstract
Ingested foreign bodies, food bolus impaction, migration or retention of medical devices are frequent, in children as well as in adults. Most of these foreign bodies will naturally pass through the gastro-intestinal tract. Complications are rare but sometimes severe (oesophageal perforations are the most frequent and most feared). We aimed to review the literature on therapeutic management of digestive foreign bodies and food bolus impaction, with special focus on endoscopic indications, material, timing and techniques for removal. The role of the gastroenterologist is to recognise specific situations and to plan endoscopic removal in a timely manner with the most adequate conditions and extraction tools. Risk factors and underlying pathology, for example eosinophilic esophagitis, must be investigated and if necessary treated.
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Affiliation(s)
- Armelle Chauvin
- Emergency Endoscopy Unit, Department of Gastroenterology, APHP, Lariboisière Hospital, & iTEC Paris Diderot Paris 7 University, Paris, France
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19
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Sarafoleanu C, Ballali S, Gregori D, Bellussi L, Passali D. Retrospective study on Romanian foreign bodies injuries in children. Int J Pediatr Otorhinolaryngol 2012; 76 Suppl 1:S73-5. [PMID: 22341472 DOI: 10.1016/j.ijporl.2012.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Foreign bodies (FB) injuries are an issue that has been recognized and investigated since many years; despite that, the impact of this subject in literature and research is still small. Such kind of injuries identifies all incidents due to ingestion, inhalation, insertion and aspiration of an object into the aero digestive tract. FBs injuries located in the upper airways can be a very serious event, sometimes resulting in fatal outcome. METHODS A retrospective study was performed on FB injuries in the aerodigestive tract in paediatric patients 1-17 years old, recorded from the ENT Department of the M. S. Curie Hospital in Bucharest. RESULTS 455 cases were reported from the M. S. Curie Hospital, ENT Department. Prevalence in female patients is higher than the males (225 males and 230 females). Mean age observed was 4.12 years. The distribution of injuries according to the retrieval location showed a higher prevalence in the nose (44.62% of cases), with a higher occurrence in females (50.74%) followed by the digestive system (24.28% of cases) were the distribution between males and females is equal. The highest prevalence was represented by nuts and seed (23.96%), followed by marble and coins (respectively 12.75% and 12.53%). CONCLUSIONS As generally described in scientific literature, injuries usually concerned toddlers and preschoolers, while school-aged children less often place foreign objects in their noses. Our results confirm the fact that when passive preventive strategies are not practical, active strategies that promote behaviour change are necessary. Active strategies require that a caregiver changes his or her behaviour each time the child begins an activity that has the potential to cause injury. Education is critical to these active strategies and plays a complementary role to environmental changes and legal mandates.
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20
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Chotigavanich C, Ballali S, Foltran F, Passali D, Bellussi L, Gregori D. Foreign bodies injuries in children: analysis of Thailand data. Int J Pediatr Otorhinolaryngol 2012; 76 Suppl 1:S80-3. [PMID: 22341474 DOI: 10.1016/j.ijporl.2012.02.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Suffocation due to foreign bodies (FB) is a leading cause of death in children aged 0-3 and it is common also in older ages, up to 14 years old. Based on the RPA report the estimated number of incidents per year in children aged 0-14 is in European Union (EU) of approximately 50,000, 10% of which are fatal. The need of an improvement of knowledge led to the development of the pan European study ESFBI (European Survey on Foreign Bodies Injuries) that collected data on FB injuries in the aerodigestive tract in paediatric patients from 19 European Hospitals (Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Germany, Greece, Italy, Poland, Romania, Slovakia, Slovenia, Spain, Sweden, Swiss, Turkey and United Kingdom). Recognizing that the rapid management is one of the main goals in the presence of such injury the aim of this paper is to confront data coming from 4 ESFBI case series with a Thailand's case series, in order to broaden the knowledge on FBs injuries characteristics, knowing that features like shape, dimension, consistency are fundamental in determine the consequences that might occur. METHODS Data coming from the Siriraj Hospital, Thailand from June 2006 to 2010 were collected and compared with 4 case series chosen amongst the ESFBI study cases (Finland, Slovenia, Sweden and Turkey). RESULTS 172 cases were collected from the Siriraj Hospital in Bangkok, Thailand. The chosen ESFBI members were Finland, Sweden, Slovenia and Turkey, with a sample numerosity respectively of 307, 235, 104 and 196 cases. All countries showed a male prevalence higher than the female one, and injuries occurred most frequently in children younger than 3 years old. The most frequent retrieval location was the digestive system (oesophagus) in Thailand data (97 cases, 56.40% of cases), whilst European cases involved more frequently the nose in Slovenia (58.65%), Finland (37.79% of cases) and Sweden (54.47%). In Turkey's case series, the highest prevalence of cases interested the airways. In Thailand and Finland case series, the main FB's type were represented by bones (respectively 66 case, 38.37% and 48 cases, 15.64%), whilst pearl, ball and marble were the most frequent FB both in Slovenia (16, 15.38%) and Sweden (83, 35.32%). Turkey case series had nuts, seeds and grain as most prevalent FB (126, 64.29%). CONCLUSIONS The nature of foreign bodies varies from country to country and is dependent on diverse cultural, social, religious and economic factors that include parental attitudes, eating habits, availability and types of potentially threatening objects, and prevention strategies. The need to study in more depth specific characteristics of foreign bodies associated with increased hazard, such as nature, size, shape, hardness or firmness, lubricity, pliability and elasticity, in order to better identify risky foods and to describe more precisely the pathogenetic pathway is therefore a necessity.
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21
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Abstract
RATIONALE AND AIM The aim of the present study is to acquire a better understanding of Non Food Foreign Bodies (NFFB) injuries in children with particular regard to the quantification of the risk of complications and hospitalization associated with patient characteristics, FB features, FB location and circumstances of the accident, as emerging from the SUSY Safe Web-Registry. METHODS The present study uses data provided by the SUSY Safe Project, a DG SANCO co-funded project which was aimed to collect as many scientific data as possible regarding Foreign Bodies (FB) injuries in children aged 0-14 years and to serve as a basis for a knowledge-based consumer protection activity in the Europe market. FBs were characterized by size, shape and consistency. Descriptive statistics (absolute and relative number or median, I and III quartile according to the categorical or continuous variable, respectively) were calculated for each considered non food item characteristics; FB features distribution by children class age and site of obstruction were assessed. Two different outcomes were considered: hospitalization and complication. FBs which most frequently cause complications were identified. The association between children age, adult presence, object characteristics and outcomes was computed using crude odds ratios and the related 95% confidence intervals. RESULTS 16,878 FB injuries in children aged 0-14 yrs have been recorded in the Susy Safe databases. FB type was specified in 10,564 cases; among them 7820 (74%) were due to a non food item. Almost two thirds of injuries occurred in patients 3 years or more old. 53% of patients were males, while 47% were females. When injury happened, the great part of children (86%) was playing. Almost 30% (2339) of injuries happened under adults' supervision. Complications occurred in 299 cases and the most documented was infections (10% of cases) followed by perforation (5%). CONCLUSIONS The inhalation/aspiration of a FB, as well as the ingestion and the insertion in the orifices of a FB may result in significant morbidity. Particularly, long-standing or hazardous foreign bodies can cause extensive damage. Some objects, because of their composition, contour, or location, are particularly hazardous: for instance, objects with sharp edges pose a significant risk of laceration and perforation, while fragments of toys have been found only in 2 cases. Parents are frequently unconscious of hazard related with some objects and they are not adequately able to promptly recognize dangerous objects and risky situations. Moreover, also clinicians seem to pay little attention to adult role in the dynamic of the accident: in fact in case series descriptions, data regarding adult presence are often under-reported. On the contrary, since many injuries to children cannot be prevented without some degree of active behavior on the part of parents, the dissemination of information regarding safe behaviors and the implementation of educational strategies aiming to improve parent's attention toward this issue could be fundamental in preventing injuries and need to be promoted by family pediatricians and health practitioners.
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Affiliation(s)
- Ivo Slapak
- Children's Medical Center of Faculty Hospital Brno, Pediatric Otolaryngology Clinic, Černopolní 9, 625 00 Brno, Czech Republic
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22
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Rodríguez H, Passali GC, Gregori D, Chinski A, Tiscornia C, Botto H, Nieto M, Zanetta A, Passali D, Cuestas G. Management of foreign bodies in the airway and oesophagus. Int J Pediatr Otorhinolaryngol 2012; 76 Suppl 1:S84-91. [PMID: 22365376 DOI: 10.1016/j.ijporl.2012.02.010] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Ingestion and/or aspiration of foreign bodies (FB) are avoidable incidents. Children between 1 and 3 years are common victims for many reasons: exploration of the environment through the mouth, lack of molars which decreases their ability to properly chew food, lack of cognitive capacity to distinguish between edible and inedible objects, and tendency to distraction and to perform other activities, like playing, whilst eating. Most FBs are expelled spontaneously, but a significant percentage impacts the upper aerodigestive tract. Approximately 80% of children's choking episodes are evaluated by pediatricians. The symptoms of aspiration or ingestion of FBs can simulate different paediatric diseases such as asthma, croup or pneumonia, delaying the correct diagnosis. SYMPTOMS There are three clinical phases both in aspiration and in ingestion of FBs: initial stage (first stage or impaction or FB) shows choking, gagging and paroxysms of coughing, obstruction of the airway (AW), occurring at the time of aspiration or ingestion. These signs calm down when the FB lodges and the reflexes grow weary (second stage or asymptomatic phase). Complications occur in the third stage (also defined as complications' phase), when the obstruction, erosion or infection cause pneumonia, atelectasis, abscess or fever (FB in AW), or dysphagia, mediastinum abscess, perforation or erosion and oesophagus (FB in the oesophagus). The first symptoms to receive medical care may actually represent a complication of impaction of FB. LOCATIONS AND MANAGEMENT: Determining the site of obstruction is important in managing the problem. The location of the FB depends on its characteristics and also on the position of the person at the time of aspiration. Determining the site of obstruction is important in managing the problem. Larynx and trachea have the lowest prevalence, except in children under 1year. They are linked with the most dangerous outcomes, complete obstruction or rupture. Bronchus is the preferred location in 80-90% of AW's cases. Esophageal FBs are twice more common than bronchial FBs, although most of these migrate to the stomach and do not require endoscopic removal. Diagnosis of FB proceeds following the traditional steps, with a particular stress on history and radiological findings as goal standards for the FB retrieval. The treatment of choice for AW's and esophageal FBs is endoscopic removal. Endoscopy should be carried out whenever the trained personnel are available, the instruments are checked, and when the techniques have been tested. The delay in the removal of FBs is potentially harmful. The communication between the endoscopist and the anaesthesiologist is essential before the procedure to establish the plan of action; full cooperation is important and improves the outcome of endoscopy. CONCLUSIONS Ingestion and or aspiration of FB in children are multifactorial in their aetiology, in their broad spectrum of different resolutions for the same FB and in the response of each patient to the treatment. Prevention remains the best treatment, implying an increased education of parents on age-appropriate foods and household items, and strict industry standards regarding the dimensions of toy parts and their secure containers.
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Affiliation(s)
- Hugo Rodríguez
- Hospital de Pediatría Juan P Garrahan, Buenos Aires, Argentina
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23
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Abstract
RATIONALE AND AIM The purpose of this study is to acquire a better understanding of Food Foreign Bodies (FFB) injuries in children characterizing the risk of complications and prolonged hospitalization due to food items according to patients' characteristics, circumstances of the accident, Foreign Body (FB) features and FB location, as emerging from the SUSY Safe Web-Registry. METHODS The present study uses data provided by the SUSY Safe Project, a DG SANCO co-funded project started in February 2005, which was aimed at establishing an international registry of cases of Foreign Bodies (FB) injuries in children aged 0-14 years. The analysis was carried out on injuries due to a food item. FB location was reported according to ICD9-CM code: ears (ICD931), nose (ICD932), pharynx and larynx (ICD933) trachea, bronchi and lungs (ICD934), mouth, esophagus and stomach (ICD935). Age and gender injury distributions were assessed. Data regarding adult supervision and activity before injury were also evaluated. FBs which most frequently cause complications were identified. The association between children age, adult presence, object characteristics and hospitalization/complications was computed using unweighted odds ratios and the related 95% confidence intervals. RESULTS 16,878 FB injuries occurred in children aged 0-14 years have been recorded in the SUSY Safe databases. FB type was specified in 10,564 cases; among them 2744 (26%) were due to a food item. FB site was recorded in 1344 cases: FB was located in the ears in 99 patients, while 1140 occurred in the upper and lower respiratory tract; finally, 105 food items were removed from mouth, esophagus and stomach. Complications occurred in 176 cases and the most documented was pulmonary or bronchial infections (23%) followed emphysema or atelectasis and by and asthma (7%). Bones were the commonest retrieved FFB encountered in this study, while nuts seem to be the FFB most frequently associated to complications. CONCLUSIONS On the basis of this study we make the strong recommendation that parents should be adequately educated and provide age-appropriate food to their children and be present in order to supervise them during eating especially during a critical period ranging from 2 to 3 years of age.
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Affiliation(s)
- Arjan B Sebastian van As
- Trauma Unit, University of Cape Town, Red Cross War Memorial Children's Hospital, Rondebosch, 7701 Cape Town, South Africa
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24
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Moretti C, Foltran F. Prevention and early recognition: the role of family pediatrician. Int J Pediatr Otorhinolaryngol 2012; 76 Suppl 1:S39-41. [PMID: 22341473 DOI: 10.1016/j.ijporl.2012.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Even if it is empirically evident that pediatricians play a key role in diagnosis, treatment and prevention of FB injuries, almost all studies have focused on the subset of injured children who receive medical care in the hospital or in the Emergency Department; moreover, a lack of scientific interest to improve information about pediatric injuries in primary care seems to exist. Primary care physicians can play an important role if they promptly identify suspect unrecognized FB aspiration in children. Moreover, prevention is a cornerstone of pediatric practice, and pediatricians, as reliable sources of information, may be efficacious in promoting injury prevention message. Given the paucity of works finalized to evaluate the role of injury preventive strategies in primary care it is arduous to identify an ideal approach to implement counseling strategies. However, evidences obtained elsewhere have suggested that effective preventive strategy origins from an effective communication technique, moreover, the probability of success is greater when the attention toward the problem is greater; particularly, the postpartum period is a time of tremendous change, increased health problems, and emotional upheaval for new parents. General practitioners are in an ideal position to assist families during this period and may consider a sooner rather than later, approach to injury prevention education.
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Affiliation(s)
- Carlo Moretti
- Pediatric Department, Azienda Ospedaliera-University of Padova, Padova, Italy.
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Abstract
OBJECTIVES to collect relevant, up-to-date, representative, accurate, systematic information, related to foreign bodies (FB) injuries. METHODS The "Susy Safe" registry, a DG SANCO co-funded project gathering data on choking in all EU Countries and beyond, was established in order to create surveillance systems for suffocation injuries able to provide a risk-analysis profile for each of the products causing the injury. Main findings after 4 years of activities are resumed here. RESULTS 16,878 FB injuries occurred in children aged 0-14 years have been recorded in the SUSY SAFE databases; 8046 cases have been reported from countries outside EU. Almost one quart of the cases involving very young children (less than one year of age) presented a FB located in bronchial tract, thus representing a major threat to their health. Esophageal foreign bodies are still characterizing injuries occurred to children younger than one year, in older children the most common locations are the ears and the nose. FB type was specified in 10,564 cases. Food objects represented the 26% of the cases, whereas non-food objects were the remaining 74%. Among food objects, the most common were bones, nuts and seed, whereas for the non-food objects pearls, balls and marbles were observed most commonly (29%). Coins were involved in 15% of the non-food injuries and toys represented the 4% of the cases. CONCLUSIONS this data collection system should be been taken into consideration for the calculation of the risk of injuries in order to provide the EU Commission with all the relevant estimates on FB injuries.
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Abstract
In this article, we reviewed our experience of treatment of cervical esophageal perforation caused by foreign bodies. Between 1980 and 2010, 42 patients were included in this study. There were 18 women and 24 men with a median age of 54 years. We divided the patients into three groups: the patients whose foreign bodies could not be extracted by otolaryngologists using endoscope (n= 7), the patients who had some signs of abscess formation but the foreign bodies had been extracted using endoscope (n= 25), and the patients who had no signs of abscess formation and the foreign bodies had been extracted (n= 10). We treated the patients of the three groups with surgical treatment, drainage alone, and conservative treatment, respectively. The outcome of the current series was favorable. Our experience suggested that most of the cases can be treated conservatively or by drainage alone. If the foreign bodies of the esophagus could not be extracted using endoscope, surgical treatment including the removal of the foreign bodies, primary repair, and drainage should be performed.
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Affiliation(s)
- J Jiang
- Department of Thoracic Surgery, Beijing Tongren Hospital Department of Thoracic Surgery, Beijing Chest Hospital, Beijing, China
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