Outcome of uncommon intestinal foreign bodies in pediatrics
DOI:
https://doi.org/10.18203/2349-2902.isj20231722Keywords:
Surgical extraction, Pediatric foreign body ingestion, Uncommon foreignAbstract
Background: Foreign body (FB) ingestion in children is very common. Children can ingest a wide variety of Foreign Bodies. Most FBs pass spontaneously through the gastrointestinal tract. Other FBs, especially uncommonly ingested objects, can present with complications and need intervention to be extracted. The aim of the study was to highlight the importance of closed observation, proper investigation, and timely intervention for uncommon gastrointestinal FBs.
Methods: This was a prospective study, conducted at pediatric surgery department, Al-Azhar University Hospitals, between November 2020 and September 2022, that included all patients who presented to our department with variously ingested FBs, were prospectively evaluated to detect those who needed surgical intervention to extract these FBs.
Results: During the specified time period, 86 patients with FB ingestion presented to our hospital. Out of these children, four patients ingested uncommon FBs, presented with symptoms of complications, and needed intervention to extract these FBs. One patient swallowed magnet tools; two patient’s swallowed toothpicks; and one patient swallowed a needle with a necklace, which was impacted in the small bowel and surgically removed.
Conclusions: Children who ingest uncommon FBs are more likely to present with complications of impaction or perforation. Negative plain films are not sufficient to conclude conservative treatment especially for radiolucent FBs. CT should be done to rule out retained and radiolucent foreign bodies; closed observation and timely intervention are mandated to avoid serious complications.
References
Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss J, Omslaer JC, et al. 2000 Annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2001;19(5):337-95.
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(8):468-72.
Chen MK, Beierle EA. Gastrointestinal foreign bodies. Pediatr Ann. 2001;30(12):736-42.
Spiers A, Jamil S, Whan E, Forbes D, Gollow I, Andrews D. Survival of patient after aorto-oesophageal fistula following button battery ingestion. ANZ J Surg. 2012;82(3):186-7.
Honzumi M, Shigemori C, Ito H, Mohri Y, Urata H, Yamamoto T. An intestinal fistula in a 3-year-old child caused by the ingestion of magnets: report of a case. Surg Today. 1995;25(6):552-3.
Bahrani Z, Busbaih Z, Busbaih J, Busbaih A. Foreign Body Removal in Indian Patient after 18 Years of Ingestion. J Surgery. 2018;6(1).
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.
Selivanov V, Sheldon GF, Cello JP, Crass RA. Management of foreign body ingestion. Ann Surg. 1984;199(2):187-91.
Goh BK, Chow PK, Quah HM, Ong HS, Eu KW, Ooi LL, et al. Perforation of the gastrointestinal tract secondary to ingestion of foreign bodies. World J Surg. 2006;30(3):372-7.
Paul RI, Jaffe DM. Sharp object ingestions in children: illustrative cases and literature review. Pediatr Emerg Care. 1988;4(4):245-8.
Klingler PJ, Seelig MH, DeVault KR, Wetscher GJ, Floch NR, Branton SA, et al. Ingested foreign bodies within the appendix: A 100-year review of the literature. Dig Dis. 1998;16(5):308-14.
Akçam M, Koçkar C, Tola HT, Duman L, Gündüz M. Endoscopic removal of an ingested pin migrated into the liver and affixed by its head to the duodenum. Gastrointest Endosc. 2009;69(2):382-4.
Karadayi S, Sahin E, Nadir A. Wandering pins: case report. Cumhuriyet Med J. 2009; 31:300-2.
McComas BC, Miles P, Katz BE. Successful salvage of an 8-month-old child with an aortoesophageal fistula. J Pediatr Surg. 1991;26(12):1394-5.
MacManus J. Perforation of the intestine by ingested foreign bodies: report of two cases and review of the literature. Am J Surg. 1941;53:393-402.
Madrona A, Fernández Hernández JA, Carrasco Prats M, Riquelme Riquelme J, Parrila Paricio P. Intestinal perforation by foreign bodies. Eur J Surg. 2000;166(4):307-9.
Daboos M, Mahfouz M, Gad D, Akl M, El-Sayed M, Alsamahy OO. Uncommon Cause of Complex Enteroenteric Fistulae in Children: A Warning Letter to the Parents. Acta Scientific Pediat. 2022;5(7):50-7.
Paediatric Surgery Trainee Research Network. Magnet and button battery ingestion in children: multicentre observational study of management and outcomes. BJS Open. 2022;6(3):zrac056.
Rami A, Al-Taher A, Muhtasbh M. Toothpick perforation of the cecum in a child mimicking acute appendicitis. J Pediatr Surg Case Rep. 2021;68: 101845.
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.
Elsherbeny MS, Allam AM, El-Asmar KM. Foreign body ingestion in children: uncommon Presentations and timely intervention. Annals Pediatr Surg. 2018;14:157-60.
