|
Abstract
|
Introduction
Foreign body (FB) ingestion is a common paediatric presentation to emergency centres in South Africa (SA). There are no guidelines for the management of FB ingestion in children in SA. This study describes the presentation, investigation, and management of FB ingestion at a tertiary paediatric trauma unit in SA.
Methods
A retrospective chart review was conducted on all children presenting to Red Cross War Memorial Children's Hospital Trauma Unit with a history of FB ingestion. Data was gathered from referral letters and hospital records, including any radiographs performed.
Results
146 patients were included with a median age of 32 months. Of these, 90% were asymptomatic at presentation. The main types of FB ingested were: 62% metallic, 14% non-metallic, and 15% food. In the metallic group, the most common FB was a coin, ingested by 45% of children. Radiographs were performed in 94% of patients, with a total of 202 radiographs performed on 137 children. The FB was identified by radiographic means in 68% of cases (39% in the oesophagus and 34% in the stomach) and removed endoscopically in 41 patients. Following endoscopy there were minor complications in 7 patients, all of which were managed conservatively.
Conclusion
The age distribution and types of FBs ingested are comparable to other published studies, though the investigation and management of FBs varied widely. Most patients with FB ingestion had several radiographs performed, exposing them to potentially harmful radiation. The use of a hand-held metal detector in emergency centres could reduce the number of radiographs performed. Guidelines for the investigation and management of FB ingestions in children in SA are necessary.
Language: en |