This study aims to elucidate the clinical presentation, the effectiveness of investigations,
and treatment of foreign body ingestion in children and to formulate an algorithm
The records of children admitted to a single institution who had a history of foreign
body ingestion over 33 years were reviewed. Symptoms, radiological findings, and endoscopic
findings were assessed.
Foreign bodies were detected in 552 (43%) of the 1,265 children admitted. The age
of the children ranged from 6 months to 16 years (mean, 5.2 years). The preschool
toddlers (mean age, 3.8 years) were most prone to ingest inanimate objects. The most
common objects were coins (49%) and nonmetallic sharp objects (NMSO; 31%). Although
x-rays could detect all the metallic objects and 86% of glass objects, the sensitivity
of fish bone detection is only 26%. Absence of symptoms was common (50% in metallic
group and 29% in NMSO group). Forty-one percent of coins and 95% of NMSO were lodged
at sites suitable for removal by direct laryngoscopy alone with success rates of 86%
and 77%, respectively. There were 3 disease-related complications and 1 mortality.
Two of these children were mentally retarded and presented late.
Efforts for prevention of ingestion of inanimate foreign body should focus on the
preschool toddler group. Particular attention should be paid to mentally retarded
children with vague gastrointestinal symptoms. Absence of symptoms does not preclude
presence of foreign body in children. Children with history of NMSO ingestion should
undergo direct laryngoscopy despite negative radiological finding, both as a screening
procedure or treatment.