Foreign body ingestion in children: Single institutional experience in Sri Lanka

Introduction: Foreign body (FB) ingestion in children is a common problem worldwide. Peak incidence is between the ages of 6 months to 4 years and children usually pass the object spontaneously without any symptoms.

Objective: To assess the pattern of FB ingestion in the Sri Lankan context.

Method: A descriptive cross sectional study was conducted from April to September 2010 at a leading tertiary care hospital. Data was collected by interviewer administered questionnaire and reviewing Bed Head Tickets.

Results: Peak incidence of FB ingestion occurred between one to four years of age (50.4%) with a slight male predominance (56.6%). None of the children were mentally challenged. Five of the children who presented with a history of ingestion had aspirated the FB and all of them required bronchoscopy to remove the object, one child also requiring intensive care unit admission. All the aspirated objects were food particles. Button battery (24.5%) and coins (17.0%) were the commonly ingested foreign bodies. Common source of button battery was the toys with which they were playing. More than half presented to the hospital asymptomatically. One third of children notified their parents about the ingestion. Expectant management was offered to 66% of the children and all of them recovered uneventfully without any intervention. Upper gastrointestinal endoscopy was used in 12 (22.6%) children to remove the FB.

Conclusions: Commonest source of FB was button batteries from toys. Most children ingested the FB despite mother’s care. Although most FB ingestion could be managed expectantly, offering appropriate intervention at the correct time prevents complications. Patient presenting with a history of FB ingestion may have aspirated the FB. As aspirated FBs are associated with significant complications, a high degree of suspicion is needed to differentiate ingestion from aspiration.

Sri Lanka Journal of Child Health, 2014; 43(2): 88-91

(Key words: Foreign body ingestion; children; Sri Lanka)

DOI: http://dx.doi.org/10.4038/sljch.v43i2.7009