Foreign body ingestion in children: a retrospective single-center analysis of 308 cases

Abstract

Purpose: Foreign body ingestion is a common pediatric emergency, particularly in young children, and may lead to a wide spectrum of clinical outcomes ranging from asymptomatic presentation to life-threatening complications. The type of ingested object, patient age, and timing of intervention are key determinants of management strategy and prognosis. To retrospectively evaluate the demographic and clinical characteristics, management strategies, and complications of pediatric foreign body ingestion cases presenting to a tertiary care center.
Materials and methods: Medical records of children aged 0-18 years who presented with foreign body ingestion between January 2017 and December 2024 were retrospectively reviewed. Demographic characteristics, clinical presentation, type and location of the ingested foreign body, management approach, and complications were analyzed.
Results: The mean age of the patients was 58.7±39.2 months, with 62% being between 1 and 5 years of age. Most patients were asymptomatic at presentation (89.6%, n=276), and diagnosis was primarily based on caregiver suspicion. The most commonly ingested objects were coins (38.0%), blunt objects (24.4%), and sharp or pointed objects (14.0%). Button batteries accounted for 8.4% of all cases. Endoscopic intervention was performed in 74 patients (24.0%), with a success rate of 91.9%. Intestinal perforation occurred in two cases: one following ingestion of a sewing needle that had passed beyond the stomach and was not visualized during endoscopic evaluation, and the other after simultaneous ingestion of multiple magnets and a button battery.
Conclusion: Most pediatric foreign body ingestions are asymptomatic and detected through caregiver awareness. The notable proportion of button battery ingestions underscores the need for improved preventive measures, including product safety and caregiver education. Furthermore, ingestion of multiple magnets poses a substantial risk for severe complications. A guideline-based, multidisciplinary management approach tailored to institutional experience is crucial to optimize outcomes and reduce morbidity.

Keywords

• Button battery
• foreign body ingestion
• children
• endoscopy
• neodymium magnets

Çocuklarda yabancı cisim yutulması: 308 olgunun retrospektif tek merkezli analizi

Abstract

Amaç: Yabancı cisim yutulması, özellikle küçük çocuklarda sık görülen bir pediatrik acil durumdur ve asemptomatik seyirden yaşamı tehdit eden komplikasyonlara kadar geniş bir klinik yelpazeye yol açabilir. Yutulan cismin türü, hastanın yaşı ve müdahale zamanlaması; yönetim stratejisi ve prognozun temel belirleyicileridir. Bu çalışmada, üçüncü basamak bir merkeze başvuran pediatrik yabancı cisim yutulması olgularının demografik ve klinik özelliklerinin, uygulanan yönetim stratejilerinin ve gelişen komplikasyonların retrospektif olarak değerlendirilmesi amaçlanmıştır.
Gereç ve yöntem: Ocak 2017-Aralık 2024 tarihleri arasında yabancı cisim yutulması nedeniyle başvuran 0-18 yaş arası çocukların tıbbi kayıtları retrospektif olarak incelendi. Demografik özellikler, klinik başvuru bulguları, yutulan yabancı cismin türü ve yerleşimi, uygulanan tedavi yaklaşımı ve komplikasyonlar analiz edildi.
Bulgular: Hastaların ortalama yaşı 58,7±39,2 ay olup, olguların %62’si 1-5 yaş grubundaydı. Hastaların büyük çoğunluğu başvuru sırasında asemptomatikti (%89,6; n=276) ve tanı çoğunlukla bakım verenlerin şüphesine dayanıyordu. En sık yutulan cisimler; madeni paralar (%38,0), künt cisimler (%24,4) ve keskin/sivri cisimler (%14,0) idi. Düğme piller tüm olguların %8,4’ünü oluşturdu. Endoskopik girişim 74 hastada (%24,0) uygulandı ve başarı oranı %91,9 olarak saptandı. İki hastada intestinal perforasyon gelişti: biri mideyi geçen ve endoskopik değerlendirmede görüntülenemeyen dikiş iğnesi yutulmasını takiben, diğeri ise birden fazla mıknatıs ile birlikte düğme pilin eşzamanlı yutulması sonrası ortaya çıktı.

Sonuç: Pediatrik yabancı cisim yutulmalarının çoğu asemptomatiktir ve bakım veren farkındalığı sayesinde saptanmaktadır. Düğme pil yutulmalarının dikkate değer oranı, ürün güvenliği ve bakım veren eğitimi dahil olmak üzere önleyici tedbirlerin güçlendirilmesi gerekliliğini ortaya koymaktadır. Ayrıca, birden fazla mıknatısın yutulması ciddi komplikasyonlar açısından yüksek risk taşımaktadır. Kurumsal deneyime uyarlanmış, kılavuz temelli ve multidisipliner bir yönetim yaklaşımı; sonuçların iyileştirilmesi ve morbiditenin azaltılması için kritik öneme sahiptir.

Keywords

• Düğme pil
• yabancı cisim yutulması
• çocuklar
• endoskopi
• neodyum mıknatıslar

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