Download PDF
CC BY 4.0 · Journal of Digestive Endoscopy 2023; 14(02): 068-073
DOI: 10.1055/s-0043-1771009
Original Article

Endoscopic Management of Pediatric Foreign Body Ingestions and Food Bolus Impactions: A Retrospective Study from a Tertiary Care Center

Syed Shafiq
1   Department of Gastroenterology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
,
Harshad Devarbhavi
1   Department of Gastroenterology, St. John's Medical College Hospital, Bengaluru, Karnataka, India
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Background Foreign body (FB) ingestion is a common pediatric problem with the majority of these occurring in children younger than 3 years. Management varies depending on the age of the patient, ingested object(s), its location along the digestive tract, and the available expertise. We aim to report our experience with endoscopic management of FB ingestions in children (<18 years).

Materials and Methods We retrospectively reviewed and analyzed endoscopic and medical records from our hospital database of all pediatric patients (<18 years) who presented with FB ingestion between January 2011 and December 2021.

Results Our analysis included a total of 368 patients. FB ingestions and/or food bolus impactions were noted in 242 and 11 children, respectively while 115 (31.25%) had spontaneously passed off FB from the digestive tract. Most common FB was coin (28.5%) followed by animal bones (26.2%). Endoscopic management of FBs and food bolus impaction was successful in 247 children (97.63%), while endoscopic FB retrieval failed in 6 children including 1 with fish bone and 5 with button batteries. A total of 9 out of 11 children with food bolus impaction had underlying esophageal pathology, the commonest being corrosive stricture (n = 7). No mortality related to endoscopic intervention was reported.

Conclusions Endoscopic retrieval of ingested FBs and food bolus impaction in children is a safe and effective approach when performed by experienced endoscopists and is associated with a high success rate and a lower incidence of complications with reduced hospital stay.

Keywords

button battery - coin - fish bone - food bolus - foreign body - stricture


Publication History

Article published online:
07 July 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Bronstein AC, Spyker DA, Cantilena Jr LR, Green JL, Rumack BH, Heard SE. American Association of Poison Control Centers. 2007 annual report of the American association of poison control centers' national poison data system (NPDS): 25th annual report. Clin Toxicol (Phila) 2008; 46 (10) 927-1057
    CrossrefPubMedSearch in Google Scholar
  • 2 Mosca S, Manes G, Martino R. et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy 2001; 33 (08) 692-696
    Thieme ConnectPubMedSearch in Google Scholar
  • 3 Birk M, Bauerfeind P, Deprez PH. et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2016; 48 (05) 489-496
    Thieme ConnectPubMedSearch in Google Scholar
  • 4 Ikenberry SO, Jue TL, Anderson MA. et al; ASGE Standards of Practice Committee. Management of ingested foreign bodies and food impactions. Gastrointest Endosc 2011; 73 (06) 1085-1091
    CrossrefPubMedSearch in Google Scholar
  • 5 Pfau PR. Removal and management of esophageal foreign bodies. Tech Gastrointest Endosc 2014; 16: 32-39
    CrossrefSearch in Google Scholar
  • 6 Becq A, Camus M, Dray X. Foreign body ingestion: dos and don'ts. Frontline Gastroenterol 2020; 12 (07) 664-670
    CrossrefPubMedSearch in Google Scholar
  • 7 Schwartz GF, Polsky HS. Ingested foreign bodies of the gastrointestinal tract. Am Surg 1976; 42 (04) 236-238
    Search in Google Scholar
  • 8 Sugawa C, Ono H, Taleb M, Lucas CE. Endoscopic management of foreign bodies in the upper gastrointestinal tract: a review. World J Gastrointest Endosc 2014; 6 (10) 475-481
    CrossrefPubMedSearch in Google Scholar
  • 9 Chiu YH, Hou SK, Chen SC. et al. Diagnosis and endoscopic management of upper gastrointestinal foreign bodies. Am J Med Sci 2012; 343 (03) 192-195
    CrossrefPubMedSearch in Google Scholar
  • 10 Zhang S, Cui Y, Gong X, Gu F, Chen M, Zhong B. Endoscopic management of foreign bodies in the upper gastrointestinal tract in South China: a retrospective study of 561 cases. Dig Dis Sci 2010; 55 (05) 1305-1312
    CrossrefPubMedSearch in Google Scholar
  • 11 Kramer RE, Lerner DG, Lin T. et al; North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Endoscopy Committee. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr 2015; 60 (04) 562-574
    CrossrefPubMedSearch in Google Scholar
  • 12 Tringali A, Thomson M, Dumonceau JM. 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 (01) 83-91
    PubMedSearch in Google Scholar
  • 13 Shafiq S, Devarbhavi H, Balaji G, Patil M. Button battery ingestion in children: Experience from a tertiary center on 56 patients. Indian J Gastroenterol 2021; 40 (05) 463-469
    CrossrefPubMedSearch in Google Scholar
  • 14 Palta R, Sahota A, Bemarki A, Salama P, Simpson N, Laine L. Foreign-body ingestion: characteristics and outcomes in a lower socioeconomic population with predominantly intentional ingestion. Gastrointest Endosc 2009; 69 (3, Pt 1): 426-433
    CrossrefPubMedSearch in Google Scholar
  • 15 Lin HH, Lee SC, Chu HC, Chang WK, Chao YC, Hsieh TY. Emergency endoscopic management of dietary foreign bodies in the esophagus. Am J Emerg Med 2007; 25 (06) 662-665
    CrossrefPubMedSearch in Google Scholar
  • 16 Little DC, Shah SR, St Peter SD. et al. Esophageal foreign bodies in the pediatric population: our first 500 cases. J Pediatr Surg 2006; 41 (05) 914-918
    CrossrefPubMedSearch in Google Scholar
  • 17 Ciriza C, García L, Suárez P. et al. What predictive parameters best indicate the need for emergent gastrointestinal endoscopy after foreign body ingestion?. J Clin Gastroenterol 2000; 31 (01) 23-28
    CrossrefPubMedSearch in Google Scholar
  • 18 Arana A, Hauser B, Hachimi-Idrissi S, Vandenplas Y. Management of ingested foreign bodies in childhood and review of the literature. Eur J Pediatr 2001; 160 (08) 468-472
    CrossrefPubMedSearch in Google Scholar
  • 19 O'Sullivan ST, Reardon CM, McGreal GT, Hehir DJ, Kirwan WO, Brady MP. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates. Ir J Med Sci 1996; 165 (04) 294-296
    CrossrefPubMedSearch in Google Scholar
  • 20 Katsinelos P, Kountouras J, Paroutoglou G, Zavos C, Mimidis K, Chatzimavroudis G. Endoscopic techniques and management of foreign body ingestion and food bolus impaction in the upper gastrointestinal tract: a retrospective analysis of 139 cases. J Clin Gastroenterol 2006; 40 (09) 784-789
    CrossrefPubMedSearch in Google Scholar
  • 21 Antoniou D, Christopoulos-Geroulanos G. Management of foreign body ingestion and food bolus impaction in children: a retrospective analysis of 675 cases. Turk J Pediatr 2011; 53 (04) 381-387
    PubMedSearch in Google Scholar
  • 22 Eisen GM, Baron TH, Dominitz JA. et al; American Society for Gastrointestinal Endoscopy. Guideline for the management of ingested foreign bodies. Gastrointest Endosc 2002; 55 (07) 802-806
    CrossrefPubMedSearch in Google Scholar
  • 23 Longstreth GF, Longstreth KJ, Yao JF. Esophageal food impaction: epidemiology and therapy. A retrospective, observational study. Gastrointest Endosc 2001; 53 (02) 193-198
    CrossrefPubMedSearch in Google Scholar
  • 24 Lacy PD, Donnelly MJ, McGrath JP, Byrne PJ, Hennessy TP, Timon CV. Acute food bolus impaction: aetiology and management. J Laryngol Otol 1997; 111 (12) 1158-1161
    CrossrefPubMedSearch in Google Scholar
  • 25 Sebastián Domingo JJ, De Diego Lorenzo A, Santos Castro L, Castellanos Franco D, Menchén P. Endoscopic management of foreign bodies in the digestive tract. Rev Esp Enferm Dig 1990; 77 (04) 259-262
    PubMedSearch in Google Scholar
  • 26 Kirchner GI, Zuber-Jerger I, Endlicher E. et al. Causes of bolus impaction in the esophagus. Surg Endosc 2011; 25 (10) 3170-3174
    CrossrefPubMedSearch in Google Scholar
  • 27 Weinstock LB, Shatz BA, Thyssen SE. Esophageal food bolus obstruction: evaluation of extraction and modified push techniques in 75 cases. Endoscopy 1999; 31 (06) 421-425
    Thieme ConnectPubMedSearch in Google Scholar
  • 28 Vicari JJ, Johanson JF, Frakes JT. Outcomes of acute esophageal food impaction: success of the push technique. Gastrointest Endosc 2001; 53 (02) 178-181
    CrossrefPubMedSearch in Google Scholar
  • 29 Schaefer TJ, Trocinski D. Esophageal Foreign Body. Treasure Island, FL: StatPearls Publishing; 2021
    Search in Google Scholar
  • 30 Caravati EM, Bennett DL, McElwee NE. Pediatric coin ingestion. A prospective study on the utility of routine roentgenograms. Am J Dis Child 1989; 143 (05) 549-551
    CrossrefPubMedSearch in Google Scholar