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Abstract
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Foreign body ingestion poses a significant health hazard in children, potentially leading to morbidity and mortality if impacted in the gastrointestinal tract. As opposed to adults, the majority of foreign body ingestions in children are accidental, often not witnessed, and mostly asympto- matic. Fifty years back in August, 1972, a research article was published in the journal on ‘Acute dysphagia due to foreign bodies in esophagus’. Through this communication, we pre- sent the changes and challenges in the management of foreign body ingestion in children which evolved over the last five decades.
The scenario described by Tandon, et al, half a century ago, highlights the magnitude of esophageal foreign body in children based on a hospital-based data from Agra, Uttar Pradesh. They reported a large series of 198 children who presented with impacted esophageal foreign body. The study population comprised of children aged 12 years or younger with a male to female ratio of 6:5. Though the maximum reported incidence of foreign body ingestion occurred in the age group between 6 months to 3 years, in that series, it was found evenly distributed across all age groups.
Foreign body ingestion continues to be one of the major causes of pediatric emergency department visits, even though the nature of ingested foreign bodiess has undergone a considerable change over the years. Children usually swallow the foreign body from house- hold products such as coins, toys, fishbone, jewelry, magnets, and button batteries. As the economy grew and metallic coins gave way to printed notes, the spectrum of ingested foreign bodies changed. Nowadays, we see fewer reports of metallic coin ingestion but more often button battery ingestion and food bolus impaction due to underlying eosinophilic esophagitis [2]. With the wide abundance of detachable batteries in consumer electric toys, the incidence of button battery ingestion has gone up exponentially [2,3]. The National Poison Data System (USA) outlined 83,459 battery ingestions from 1985 to 2017, 77% in children younger than 6 years [4]. In a recent Indian study, it was observed that 50% of ingested batteries in children were removed from a product (mainly from hearing aids, remote controls), 30% from toys, and the remaining 20% from unused cells, watches etc. [5]. Related morbidity and mortality have sharply risen in the last decade due to the use of more powerful (3.0 V vs 1.5 V) and bigger (>20 mm) lithium battery as compared to traditional alkaline button battery. Button battery causes necrosis of esophageal walls due to electric current, leakage of chemicals as well as pressure necrosis ...
Language: en |