title: Selective upper endoscopy for foreign body ingestion in children: an evaluation of management protocol after 282 cases.
abstract: OBJECTIVE
  Foreign body ingestion is a common problem in both children and adults. This study aims to evaluate a management protocol where endoscopic examination was only selectively used after routine direct laryngoscopy to minimize patient discomfort and the need for general anesthesia in children.
  
  
  METHODS
  A management protocol for foreign body ingestion based on symptoms was introduced in 1998 and records of children admitted to a university-affiliated hospital between January 1999 and October 2005 with suspected foreign body ingestion were evaluated. Symptoms, radiologic and endoscopic findings, and outcome were reviewed.
  
  
  RESULTS
  A total of 282 patients were admitted. The mean age of patients was 5.75 years (range, 9 months to 17 years). There were 167 boys and 115 girls. Based on our protocol, 84 (29.8%) patients required an upper endoscopy. Fish bones were most commonly involved (68.8%). Foreign bodies, which were either removed or dislodged, were found during upper endoscopy in only 25 (8.8%) patients overall. All patients had an uneventful outcome. No complications or mortalities were encountered. There were no readmissions for those who did not undergo endoscopic examination.
  
  
  CONCLUSIONS
  It is safe to selectively perform upper endoscopy depending on symptoms when managing children with foreign body ingestion.
authors.affiliation: Department of Surgery, University of Hong Kong Medical Center, Queen Mary Hospital, Hong Kong, SAR, China.
authors.forename: Kenneth K Y
authors.initials: KK
authors.lastname: Wong
authors.forename: Christian X
authors.initials: CX
authors.lastname: Fang
authors.forename: Paul K H
authors.initials: PK
authors.lastname: Tam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016145:Endoscopy, Digestive System; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies