Ingested foreign bodies in the paediatric patient.
BACKGROUND
Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention.


OBJECTIVE
To establish clear guidelines for management of paediatric FB ingestion.


METHODS
A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999.


RESULTS
Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery.


CONCLUSIONS
Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.
O'Brien
G C
GC
Department of Surgery, Cork University Hospital, Cork, Ireland.
Winter
D C
DC
Kirwan
W O
WO
Redmond
H P
HP
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004064:Digestive System; D005260:Female; D005547:Foreign Bodies / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies