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Open Access 01-12-2020 | Foreign Body Aspiration | Research article

Increase in foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

Authors: Arne Jorma Speidel, Lena Wölfle, Benjamin Mayer, Carsten Posovszky

Published in: BMC Pediatrics | Issue 1/2020

Abstract

Background

Children with a history of caustic or foreign body ingestion (FBI) seem to be presenting more frequently to emergency departments. This study aims to elucidate the clinical presentation, diagnostic procedures, and complications associated with the ingestion of different object categories over a 13-year time period.

Methods

A structured retrospective data analysis of patients who presented between January 2005 and December 2017 to the University Medical Centre Ulm was performed. Patients up to 17 years of age with food impaction or foreign body or harmful substance ingestion were included by selection of the corresponding International Statistical Classification of Diseases and Related Health Problems (ICD10-GM) codes. Descriptive statistics, parametric or non-parametric tests, and linear regression analysis were performed.

Result

In total, 1199 patients were analysed; the mean age was 3.3 years (SD 3.12; range 7 days to 16 years), the male to female ratio was 1.15:1, and 194 (16.2%) were hospitalized. The number of patients seen annually increased from 66 in 2005 to 119 in 2017, with a rise in percentage of all emergency patients from 0.82% in 2010 to 1.34% in 2017. The majority of patients (n = 619) had no symptoms, and 244 out of 580 symptomatic patients complained of retching or vomiting. Most frequently, ingested objects were coins (18.8%). Radiopaque objects accounted for 47.6%, and sharp objects accounted for 10.5% of the ingested foreign bodies, both of which were significantly more often ingested by girls (p < 0.001 for both). Button battery ingestion was recorded for 63 patients with a significant annual increase (R2 = 0.57; β = 0.753; p = 0.003). The annual rate of complications also increased significantly (R2 = 0.42; β = 0.647; p = 0.017).

Conclusion

We found an alarming increase in the number of children who presented to our emergency department with FBI and associated complications. A standardized diagnostic and therapeutic approach may reduce and prevent serious complications. Further preventive measures within the home environment are needed to stop this trend.

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Cheng W, Tam PK. Foreign-body ingestion in children: experience with 1,265 cases. J Pediatr Surg. 1999;34(10):1472–6.PubMedCrossRef

Khorana J, Tantivit Y, Phiuphong C, Pattapong S, Siripan S. Foreign body ingestion in pediatrics: distribution, management and complications. Medicina (Kaunas). 2019;55(10):686.CrossRef

Kay M, Wyllie R. Caustic ingestions in children. Curr Opin Pediatr. 2009;21(5):651–4.PubMedCrossRef

Gregori D, Scarinzi C, Morra B, Salerni L, Berchialla P, Snidero S, Corradetti R, Passali D, Group ES. Ingested foreign bodies causing complications and requiring hospitalization in European children: results from the ESFBI study. Pediatr Int. 2010;52(1):26–32.PubMedCrossRef

Jayachandra S, Eslick GD. A systematic review of paediatric foreign body ingestion: presentation, complications, and management. Int J Pediatr Otorhinolaryngol. 2013;77(3):311–7.PubMedCrossRef

Hesham AKH. Foreign body ingestion: children like to put objects in their mouth. World J Pediatr. 2010;6(4):301–10.CrossRef

Lee JH. Foreign body ingestion in children. Clin Endosc. 2018;51(2):129–36.PubMedPubMedCentralCrossRef

Orsagh-Yentis D, McAdams RJ, Roberts KJ, LB MK. Foreign-body ingestions of young children treated in US emergency departments: 1995-2015. Pediatrics. 2019;143(5):e20181988.PubMedCrossRef

Elshabrawi M, AK HH. Caustic ingestion in children. Expert Rev Gastroenterol Hepatol. 2011;5(5):637–45.PubMedCrossRef

10.

Reeves PT, Nylund CM, Krishnamurthy J, Noel RA, Abbas MI. Trends of magnet ingestion in children, an ironic attraction. J Pediatr Gastroenterol Nutr. 2018;66(5):e116–21.PubMedCrossRef

11.

Denney W, Ahmad N, Dillard B, Nowicki MJ. Children will eat the strangest things: a 10-year retrospective analysis of foreign body and caustic ingestions from a single academic center. Pediatr Emerg Care. 2012;28(8):731–4.PubMedCrossRef

12.

Crysdale WS, Sendi KS, Yoo J. Esophageal foreign bodies in children. 15-year review of 484 cases. Ann Otol Rhinol Laryngol. 1991;100(4 Pt 1):320–4.PubMedCrossRef

13.

Lee JH, Lee JS, Kim MJ, Choe YH. Initial location determines spontaneous passage of foreign bodies from the gastrointestinal tract in children. Pediatr Emerg Care. 2011;27(4):284–9.PubMedCrossRef

14.

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.PubMedPubMedCentralCrossRef

15.

Russell R, Lucas A, Johnson J, Yannam G, Griffin R, Beierle E, Anderson S, Chen M, Harmon C. Extraction of esophageal foreign bodies in children: rigid versus flexible endoscopy. Pediatr Surg Int. 2014;30(4):417–22.PubMedCrossRef

16.

Choe JY, Choe BH. Foreign body removal in children using Foley catheter or magnet tube from gastrointestinal tract. Pediatr Gastroenterol Hepatol Nutr. 2019;22(2):132–41.PubMedPubMedCentralCrossRef

17.

Jatana KR, Litovitz T, Reilly JS, Koltai PJ, Rider G, Jacobs IN. Pediatric button battery injuries: 2013 task force update. Int J Pediatr Otorhinolaryngol. 2013;77(9):1392–9.PubMedCrossRef

18.

Varga A, Kovacs T, Saxena AK. Analysis of complications after button battery ingestion in children. Pediatr Emerg Care. 2018;34(6):443–6.PubMedCrossRef

19.

Krom H, Visser M, Hulst JM, Wolters VM, Van den Neucker AM, de Meij T, van der Doef HPJ, Norbruis OF, Benninga MA, Smit MJM, et al. Serious complications after button battery ingestion in children. Eur J Pediatr. 2018;177(7):1063–70.PubMedPubMedCentralCrossRef

20.

Committee ASoP, Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Decker GA, Fanelli RD, Fisher LR, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73(6):1085–91.CrossRef

21.

Abbas MI, Oliva-Hemker M, Choi J, Lustik M, Gilger MA, Noel RA, Schwarz K, Nylund CM. Magnet ingestions in children presenting to US emergency departments, 2002-2011. J Pediatr Gastroenterol Nutr. 2013;57(1):18–22.PubMedCrossRef

22.

Tringali A, Thomson M, Dumonceau JM, Tavares M, Tabbers MM, Furlano R, Spaander M, Hassan C, Tzvinikos C, Ijsselstijn H, et al. Pediatric gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guideline executive summary. Endoscopy. 2017;49(1):83–91.PubMed

23.

De Matteis A, Pagliaro G, Corleto VD, Pacchiarotti C, Di Giulio E, Villa MP, Parisi P, Vassallo F, Ziparo C, Di Nardo G. Eosinophilic esophagitis in children: clinical findings and diagnostic approach. Curr Pediatr Rev. 2019;16(3):206–14.

24.

Geng LL, Liang CP, Chen PY, Wu Q, Yang M, Li HW, Xu ZH, Ren L, Wang HL, Cheng S, et al. Long-term outcomes of caustic esophageal stricture with endoscopic balloon dilatation in Chinese children. Gastroenterol Res Pract. 2018;2018:8352756.PubMedPubMedCentralCrossRef

25.

Gerner P, Pallacks F, Laschat M, Hermanns-Clausen M. Health damages after ingestion of button batteries in childhood. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2019;62(11):1354–61.PubMedCrossRef

26.

Witzleben AV, Reiter R, Hoffmann T, Posovszky C. Buried foreign body in the esophagus - unusual cause of dysphagia in a 2-year-old child. Klinische Padiatrie. 2019;231(4):214–6.PubMedCrossRef

27.

Schmid MB, Posovszky C, Neuwirth F, Galm C, Keck T. Foreign body ingestion in children: recommendation for the diagnostic and therapeutic procedure. Laryngo- rhino- otologie. 2010;89(2):73–6.PubMedCrossRef

28.

Hiremath GS, Hameed F, Pacheco A, Olive A, Davis CM, Shulman RJ. Esophageal food impaction and Eosinophilic esophagitis: a retrospective study, systematic review, and meta-analysis. Dig Dis Sci. 2015;60(11):3181–93.PubMedPubMedCentralCrossRef

29.

Sahn B, Mamula P, Ford CA. Review of foreign body ingestion and esophageal food impaction management in adolescents. J Adolesc Health. 2014;55(2):260–6.PubMedCrossRef

30.

Chinski A, Foltran F, Gregori D, Ballali S, Passali D, Bellussi L. Foreign bodies in children: a comparison between Argentina and Europe. Int J Pediatr Otorhinolaryngol. 2012;76(Suppl 1):S76–9.PubMedCrossRef

31.

Sink JR, Kitsko DJ, Mehta DK, Georg MW, Simons JP. Diagnosis of pediatric foreign body ingestion: clinical presentation, physical examination, and radiologic findings. Ann Otol Rhinol Laryngol. 2016;125(4):342–50.PubMedCrossRef

32.

Trout AT, Towbin AJ. Seasonal foreign bodies: the dangers of winter holiday ornamentation. Pediatr Radiol. 2014;44(12):1610–6.PubMedCrossRef

33.

Arevalo-Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M. Ingestion of caustic substances: a 15-year experience. Laryngoscope. 2006;116(8):1422–6.PubMedCrossRef

34.

Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. Pediatrics. 2010;125(6):1168–77.PubMedCrossRef

35.

Sharpe SJ, Rochette LM, Smith GA. Pediatric battery-related emergency department visits in the United States, 1990-2009. Pediatrics. 2012;129(6):1111–7.PubMedCrossRef

36.

Rybojad B, Niedzielska G, Niedzielski A, Rudnicka-Drozak E, Rybojad P. Esophageal foreign bodies in pediatric patients: a thirteen-year retrospective study. ScientificWorldJournal. 2012;2012:102642.PubMedPubMedCentralCrossRef

37.

Yuan J, Ma M, Guo Y, He B, Cai Z, Ye B, Xu L, Liu J, Ding J, Zheng Z, et al. Delayed endoscopic removal of sharp foreign body in the esophagus increased clinical complications: an experience from multiple centers in China. Medicine. 2019;98(26):e16146.PubMedPubMedCentralCrossRef

38.

Laya BF, Restrepo R, Lee EY. Practical imaging evaluation of foreign bodies in children: an update. Radiol Clin N Am. 2017;55(4):845–67.PubMedCrossRef

39.

Nation J, Jiang W. The utility of a handheld metal detector in detection and localization of pediatric metallic foreign body ingestion. Int J Pediatr Otorhinolaryngol. 2017;92:1–6.PubMedCrossRef

40.

Ramlakhan SL, Burke DP, Gilchrist J. Things that go beep: experience with an ED guideline for use of a handheld metal detector in the management of ingested non-hazardous metallic foreign bodies. Emerg Med J. 2006;23(6):456–60.PubMedPubMedCentralCrossRef

41.

Lee JB, Ahmad S, Gale CP. Detection of coins ingested by children using a handheld metal detector: a systematic review. Emerg Med J. 2005;22(12):839–44.PubMedPubMedCentralCrossRef

42.

Tseng CC, Hsiao TY, Hsu WC. Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency. Journal of the Formosan Medical Association = Taiwan yi zhi. 2016;115(8):639–44.PubMedCrossRef

43.

Shinhar SY, Strabbing RJ, Madgy DN. Esophagoscopy for removal of foreign bodies in the pediatric population. Int J Pediatr Otorhinolaryngol. 2003;67(9):977–9.PubMedCrossRef

44.

Committee ASoP, Lightdale JR, Acosta R, Shergill AK, Chandrasekhara V, Chathadi K, Early D, Evans JA, Fanelli RD, Fisher DA, et al. Modifications in endoscopic practice for pediatric patients. Gastrointest Endosc. 2014;79(5):699–710.CrossRef

45.

van AS AB S, Yusof AM, Millar AJ, Susy Safe Working G. Food foreign body injuries. Int J Pediatr Otorhinolaryngol. 2012;76(Suppl 1):S20–5.PubMed

46.

Krishnan U. Eosinophilic esophagitis in children with esophageal atresia. Eur J Pediatr Surg. 2015;25(4):336–44.PubMedCrossRef

47.

Williams P, Jameson S, Bishop P, Sawaya D, Nowicki M. Esophageal foreign bodies and eosinophilic esophagitis--the need for esophageal mucosal biopsy: a 12-year survey across pediatric subspecialties. Surg Endosc. 2013;27(6):2216–20.PubMedCrossRef

48.

De Roo AC, Thompson MC, Chounthirath T, Xiang H, Cowles NA, Shmuylovskaya L, Smith GA. Rare-earth magnet ingestion-related injuries among children, 2000-2012. Clin Pediatr. 2013;52(11):1006–13.CrossRef

49.

Liu S, Li J, Lv Y. Gastrointestinal damage caused by swallowing multiple magnets. Front Med. 2012;6(3):280–7.PubMedCrossRef

50.

Yalcin S, Karnak I, Ciftci AO, Senocak ME, Tanyel FC, Buyukpamukcu N. Foreign body ingestion in children: an analysis of pediatric surgical practice. Pediatr Surg Int. 2007;23(8):755–61.PubMedCrossRef

51.

Betalli P, Falchetti D, Giuliani S, Pane A, Dall'Oglio L, de Angelis GL, Caldore M, Romano C, Gamba P, Baldo V, et al. Caustic ingestion in children: is endoscopy always indicated? The results of an Italian multicenter observational study. Gastrointest Endosc. 2008;68(3):434–9.PubMedCrossRef

52.

Prevention CfDCa. Injuries from Batteries Among Children Aged <13 Years — United States, 1995–2010. MMWR Morb Mortal Wkly Rep. 2012;61(34):661.

53.

Litovitz T, Whitaker N, Clark L. Preventing battery ingestions: an analysis of 8648 cases. Pediatrics. 2010;125(6):1178–83.PubMedCrossRef

Title: Increase in foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017
Authors: Arne Jorma Speidel
Lena Wölfle
Benjamin Mayer
Carsten Posovszky
Publication date: 01-12-2020
Publisher: BioMed Central
Keyword: Foreign Body Aspiration
Published in: BMC Pediatrics / Issue 1/2020
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-020-02444-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Increase in foreign body and harmful substance ingestion and associated complications in children: a retrospective study of 1199 cases from 2005 to 2017

Abstract

Background

Methods

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

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