Ingested foreign bodies in the paediatric patient

Background. Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. Aims. To establish clear guidelines for management of paediatric FB ingestion. Methods. A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. Results. Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. Conclusion. Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.