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.
Ileovesical fistula is a rare condition in children. A case of 13 year-old female with ileovesical fistula caused by an ingested foreign material is presented. She had dysuria and lower abdominal pain for one month. There was no history of medico-surgical illness such as Crohn's disease or diverticulitis. Preoperative imaging study showed a movable calcified object in the pelvic cavity and air bubbles in the bladder. At laparotomy a bezoar-like mass was found at the antimesenteric border of the terminal ileum adherent to the dome of bladder. Segmental resection of the ileum and partial cystectomy were performed.
Foreign body ingestion is a frequent event in the pediatric age group, but the incidence of foreign bodies in the appendix is very low. The authors report a case of ingested foreign body trapped in the appendix in a 7-year-old girl. The foreign body was successfully treated by laparoscopic appendectomy under fluoroscopic guidance.
Ingested foreign bodies are common occurrences in the pediatric population. From October 2002 to April 2006, eight patients (6 male, mean age: 30.9±14.4 months, range: 7~45 months) who had ingested metallic foreign bodies, such as bar magnets, coin-type magnets, screws, metal beads, and disk batteries, were selected for foreign body removal using a magnetic device under floroscopic control. A 1-cm-long cylindrical magnet (6mm in diameter) was placed at the end of a 150-cm-long plastic tube from an IV set. The magnet was passed through the mouth into the stomach. Under fluoroscopic control, the magnet was maneuvered so that it attached to the metallic foreign bodies. The forgeign body was then easily removed by retracting the magnet with the metallic object attached. This procedure was successful in six patients of 8 patients. This procedure is a minimally-invasive and may avoid the use of anesthesics, endoscopy or surgery.
Chronic duodenal obstruction related to a congenital web is a rare anomaly that is sometimes difficult to diagnose preoperatively. A case of partial duodenal obstruction along with a foreign body by a congenital duodenal web in a 10-year-old girl is presented. She has had one year history of intermittent epigastric discomfort without nausea, vomiting and growth retardation. The studies including UGI series and gastroduodenoscopy disclosed a perforated web in the 2nd portion of the duodenum and a dark go stone just proximal to the web. Via a longitudinal duodenotomy across the web, the web was partly excised with preservation of ampulla of Vater and the duodenum was closed in transverse fashion. The aperture of ampulla of Vater was located at 7 o'clock direction of posterior surface of the duodenal web. This particular case reminds clinicians to consider a duodenal web in a youngster presenting with a longstanding foreign body in the duodenum as one of the underlying pathologies.
Children tend to ingest foreign bodies. The majority present in children between the ages of 6 months and 3 years. We experienced 2 cases of unusual gastrointestinal complications caused by ingested foreign bodies. First case was a 10-month-old male with intestinal perforation due to two pieces of ingested magnetic beads. Second case was a 7-month-old girl with esophageal stricture due to an ingested particle of plastic toy.