Consultations for digestive foreign bodies ingestion in a pediatric emergency department

Abstract

Background: Foreign body (FB) ingestion distresses many families who consult the emergency department promptly. The objective of the study is to determine the epidemiological characteristics of children who consult due to suspected FB intake and its consequences. Methods: Descriptive-observational study, carried out in a third-level maternal and child center. Emergency reports were selected from patients under 18 years of age with a diagnosis of discharge “Ingesta CE” (code 938 CIM-9-MC until May 2018; code T18.9XXA CIM-10- MC later) from 1/1/2017 until 12/31/2018. Miscoded and reconsultations within the same episode were excluded. Data was analysed with the statistics program SPSS 25.0. Results: 458 cases were included; median age 3.8 years (p25-75: 1.9-6.6 years); 267 (58.3%) males. 78.9% consulted in the first 6 hours after intake. Accidental cause was reported in 98.9% of cases. In 96.7% a single FB was ingested. The most frequent types of object were metallic (46.7%), plastics (16.4%) and food bones/shells (12.9%). The 23.6% of FB involved were sharp/pointed. 49.1% of the patients presented symptoms. A complementary test was performed in 69.4%, especially radiographs (63.5%). Metal detector was used in 10%. 9.6% required endoscopy. 90.4% were discharged from the emergency department, with 12.1% of reconsultations. Conclusions: Consultations for FB ingestion are relatively frequent in the emergency department and, although most of them are discharged, many patients require complementary tests and a non-negligible number, endoscopy. The patient’s profile is that of a preschooler who spontaneously goes to the emergency room due to an accidental ingestion of a blunt metallic object.