Research Article: High-Risk foreign body ingestion in children: clinical features and endoscopic outcomes
Abstract:
To evaluate clinical features and endoscopic outcomes in children with high-risk upper gastrointestinal (GI) foreign bodies, stratified by object type.
We retrospectively reviewed cases of children who ingested high-risk foreign bodies with upper GI retention at a Chinese tertiary pediatric center (January 2020–December 2024). Patients were stratified by the type of ingested foreign body: sharp objects, magnetic objects, or button batteries. Demographics, symptoms, retention sites, injuries, complications, and outcomes were analyzed.
Among 155 children, 61 (39.4%) ingested sharp objects, 42 (27.1%) magnetic objects, and 52 (33.5%) button batteries. All underwent attempted endoscopic retrieval. Groups differed significantly in age, retention site, and ingestion-to-presentation duration (all P <?0.05). Button battery ingestions occurred predominantly in children aged 0–3 years; sharp objects predominantly lodged in the esophagus, while magnets and button batteries were mainly retained in the stomach. Magnetic ingestions had the longest duration (>24?h) because they were often asymptomatic. Pain was more common with sharp and magnetic objects ( P <?0.05); vomiting and perforation rates were highest in the magnetic group ( P <?0.05), likely because only cases involving ?2 magnets were included. Dysphagia was more frequent with sharp objects and batteries ( P <?0.05). Esophagogastroduodenoscopy (EGD) was first-line with a success rate of 96.1%; two sharp cases needed rigid esophagoscopy, and the magnetic group had higher surgical rates ( P <?0.05).
High-risk foreign body ingestion is dangerous, especially ingestion of multiple magnetic foreign bodies, which are associated with high perforation and surgical rates. EGD is effective first-line therapy. Urgent intervention is needed for multiple magnets (even asymptomatic) and delayed cases. Post-removal follow-up is important, and our comparative analysis guides risk-stratified management.
Introduction:
Foreign body ingestion is a common pediatric emergency and an important public health concern. Although historical anecdotes of foreign body ingestion date back centuries, modern clinical documentation began in the mid-20th century ( 1 ). Historically, trichobezoars (hairballs) were among the most frequently reported ingested foreign bodies in children. However, with changes in household items and toy design, the spectrum of ingested objects has dramatically diversified, now including coins, toy parts, electric…
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