Frequency, clinical findings and outcome of foreign bodies in the upper gastrointestinal tract

Background: Foreign body ingestion is a potentially serious problem in children. Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (20%) need endoscopic or surgical removal. Sharp foreign object may cause serious complications and need an emergency intervention. The aim of this study was to characterize the clinical features associated with foreign bodies in the upper gastrointestinal tract and to determine the clinical factors for their successful removal by endoscopic techniques.
Methods: We analyzed retrospectively 120 cases of foreign bodies in the upper gastrointestinal tract at Children's Medical Center, Tehran. Depending on the type of the swallowed foreign body and its site obtained by routine neck and chest x-ray as well as existing symptoms, we decided to fulfill an emergency endoscopy or to wait.
Findings: Of 120 patients with a mean age of 4 years, 75 (62.5%) were males and 45 (37.5%) females. There was a history of parents' presence as a witness in 93.3% of cases. Common sites of foreign bodies were stomach (66.6%), esophagus (25%), and duodenum (2.5%); a coin was the most common foreign body (30%). Other foreign bodies were disc battery (12.5%), and sharp foreign bodies (10%). Most of patients were brought in the first 24 hours after ingestion of the foreign body. In only 8 patients, complications occurred.
Conclusion: Foreign body ingestion in children is a serious problem which may need an emergency procedure. Still the best way is its prevention; children should not be allowed to play with coins, metallic objects, safety pins etc.