A prospective study of foreign-body ingestion in 311 children
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AbstractObjective: To determine the preferable management protocol of foreign body ingestion in pediatric patients. Methods: All pediatric patients aged less than 12 years who presented with suspected foreign body ingestion in a hospital setting over a period of 3 years were prospectively studied. The usefulness of symptoms and various diagnostic procedures to identify the impacted foreign bodies were analyzed. Results: Of 311 children aged 4 months to 12 years, 115 foreign bodies were encountered. The presentations in children aged younger than 5 years were markedly different from the older children, who behaved more like adults. All sharp foreign bodies (107 cases or 93%), mostly fish bones (90.4%), were found in the oropharynx under direct vision using either tongue depressor (57%), Macintosh laryngoscope (6%). indirect laryngeal mirror (2%,) or transnasal flexible endoscopy (28%). Coins (eight cases or 7%) were the only foreign body impacted at or below the level of cricopharyngeus. A plain cervical X-ray has a low sensitivity (15.9%) and a high specificity (99.5%) in identifying the foreign bodies. Conclusions: As the majority of the foreign bodies were sharp bones and situated in the oropharynx, a management protocol involving examination with a tongue depressor, transnasal larynoscope, selective lateral soft tissue neck X-ray, chest X-ray and watchful observation is usually adequate. Removal of these foreign bodies can be accomplished using a tongue depressor and Macintosh laryngoscope. Patients with a suspected coin ingestion have to be evaluated by X-ray, and a rigid pharyngo-oesophagoscopy should be the mainstay of treatment. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
All Author(s) ListPak MW, Lee WC, Fung HK, van Hasselt CA
Journal nameInternational Journal of Pediatric Otorhinolaryngology
Year2001
Month4
Day6
Volume Number58
Issue Number1
PublisherELSEVIER SCI IRELAND LTD
Pages37 - 45
ISSN0165-5876
eISSN1872-8464
LanguagesEnglish-United Kingdom
Keywordschildren; diagnosis; foreign body; management; radiography
Web of Science Subject CategoriesOtorhinolaryngology; OTORHINOLARYNGOLOGY; Pediatrics; PEDIATRICS

Last updated on 2020-29-06 at 02:17