Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

Eunsoo Choi; Hyo Gyun Lee; Soo Jin Na Choi; Sang Young Chung

doi:10.13029/jkaps.2014.20.1.12

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Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

Eunsoo Choi, Hyo Gyun Lee, Soo Jin Na Choi, Sang Young Chung

Journal of the Korean Association of Pediatric Surgeons 2014;20(1):12-16.
Published online: June 30, 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.1.12

Department of Surgery, Chonnam National University School of Medicine, Gwangju, Korea

Correspondence: Soo Jin Na Choi, Department of Surgery, Chonnam National University School of Medicine, 42, Jebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel: 062-220-6473, Fax: 062-227-1635, E-mail: choisjn@chonnam.ac.kr

• Received: April 10, 2014 • Accepted: June 5, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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ABSTRACT
REFERENCES

ABSTRACT

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.
Keywords: Foreign body; Gastrointestinal tract; Children

Fig. 1.

Schematic review of management and results of foreign bodies ingested patients. ER: emergency room, EGD: esophagogastroduodenoscopy, F/U: follow up.

Fig. 2.

(A) Impaction of foreign body in appendix (gold accessory). (B) Impaction of foreign body in small intestine (hair pin).

Fig. 3.

(A) Perforation of duodenal second portion by hair pin. (B) Perforation of gastric greater curvature and jejunum by two magnets.

Table 1.

Age Distribution of the 273 Children

Table 1.
Age (yr)	Number of patients (%)
＜1	14 (5.1)
1∼3	171 (62.6)
4∼6	52 (19.1)
7∼9	25 (9.2)
10∼18	11 (4.0)
Total	273 (100)

Table 2.

Nature and Frequency of Ingested Foreign Bodies

Table 2.
Foreign bodies	Number of cases (%)
Coins	80 (29.3)
Button batteries	41 (15.0)
Sharp objects	39 (14.3)
Magnets	13 (4.8)
Other objects	100 (36.6)
Total	273 (100)

Table 3.

Complications according to the Type of Foreign Bodies

Table 3.
Foreign bodies (number of cases)	Complications	Number of cases (%)
Coins (80)	Esophageal ulcer	2	1	(2.5)
Coins (80)	Esophageal stricture		1
Button batteries (41)	Mallory-weiss tearing	8	1	(19.5)
	Acute gastritis		2
	Gastric erosion		2
	Gastric ulcer		3
Sharp objects (39)	Esophageal ulcer	3	1	(7.7)
Sharp objects (39)	Duodenum perforation		2
Magnets (13)	Gastric ulcer	6	1	(46.2)
	Gastric perforation		1
	Colon perforation		1
	Small intestine perforation		3
Other objects (100)	Acute gastritis	4	4	(4)
Total (273)		23		(8.4)

REFERENCES

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Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

J Korean Assoc Pediatr Surg. 2014;20(1):12-16. Published online June 30, 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.1.12

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Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

J Korean Assoc Pediatr Surg. 2014;20(1):12-16. Published online June 30, 2014

DOI: https://doi.org/10.13029/jkaps.2014.20.1.12

Figure

Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

Fig. 1. Schematic review of management and results of foreign bodies ingested patients. ER: emergency room, EGD: esophagogastroduodenoscopy, F/U: follow up.

Fig. 2. (A) Impaction of foreign body in appendix (gold accessory). (B) Impaction of foreign body in small intestine (hair pin).

Fig. 3. (A) Perforation of duodenal second portion by hair pin. (B) Perforation of gastric greater curvature and jejunum by two magnets.

Fig. 1.

Fig. 2.

Fig. 3.

Clinical Analysis of Foreign Bodies in Gastrointestinal Tract in Children

Age (yr)	Number of patients (%)
＜1	14 (5.1)
1∼3	171 (62.6)
4∼6	52 (19.1)
7∼9	25 (9.2)
10∼18	11 (4.0)
Total	273 (100)

Foreign bodies	Number of cases (%)
Coins	80 (29.3)
Button batteries	41 (15.0)
Sharp objects	39 (14.3)
Magnets	13 (4.8)
Other objects	100 (36.6)
Total	273 (100)

Foreign bodies (number of cases)	Complications	Number of cases (%)
Coins (80)	Esophageal ulcer	2	1	(2.5)
Coins (80)	Esophageal stricture		1
Button batteries (41)	Mallory-weiss tearing	8	1	(19.5)
	Acute gastritis		2
	Gastric erosion		2
	Gastric ulcer		3
Sharp objects (39)	Esophageal ulcer	3	1	(7.7)
Sharp objects (39)	Duodenum perforation		2
Magnets (13)	Gastric ulcer	6	1	(46.2)
	Gastric perforation		1
	Colon perforation		1
	Small intestine perforation		3
Other objects (100)	Acute gastritis	4	4	(4)
Total (273)		23		(8.4)

Table 1. Age Distribution of the 273 Children

Table 2. Nature and Frequency of Ingested Foreign Bodies

Table 3. Complications according to the Type of Foreign Bodies

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