PREDICTORS OF NATURE OF INGESTED FOREIGN BODIES IN CHILDREN & ASSESSMENT OF OPERATIVE OUTCOMES

Publication date: Available online 24 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Rubeena Arora, Sunil Kumar, Gautam Bir Singh

Abstract

OBJECTIVE

To examine sensitivity/specificity of history & radiology to identify ingested foreign body (FB) and develop a protocol for management of ingested FBs in paediatric patients; to assess outcomes of removal of lithium button battery foreign body (LBBFB).

METHODS

Retrospective review. Children presenting to ENT emergency with suspected FB ingestion underwent rigid esophagoscopy and FB removal. Average age, number of attempts, duration of ingestion, success rate, and complications were analysed.

RESULTS

Cases of coin/LBBFB ingestion: 916/70. Mean age: 5.8/2.03 years (p<0.001). Average duration of ingestion: 37/9.5 h (p<0.001). Patients below 3: 31.3/62.8% (p<0.001). Suggestive history/radiological signs: 100%/100%, 75.7%/98.6% (p<0.0001). Site of impaction cricopharynx: 60.3%/74.3% (p=0.02). LBBFB group: Successful removal in 1^st attempt: 66 (94.3%). Cases requiring multiple attempts due to impaction: 4 (5.7%). Parenteral steroids were administered before successful reattempt. No relation was found between duration of ingestion/impaction. Five (7.1%) cases developed complications. Average follow-up duration: 13.59 months.

CONCLUSIONS

Children <3 years with vague history of FB ingestion and suggestive chest x-ray should be sent urgently for FB removal. Parenteral pre-and postoperative short course steroid use may be considered to improve outcomes.

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