Rubeena Arora1, Sunil Kumar2, Gautam Bir Singh2. 1. Department of Otorhinolaryngology, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India. Electronic address: irarora234@rediffmail.com. 2. Department of Otorhinolaryngology, Lady Hardinge Medical College & Associated Hospitals, Shaheed Bhagat Singh Marg, New Delhi, 110001, India.
Abstract
OBJECTIVE: To examine sensitivity/specificity of history & radiology to identify ingested foreign body (FB) and develop a protocol for management of ingested FBs in paediatric patients; to assess outcomes of removal of lithium button battery foreign body (LBBFB). METHODS: Retrospective review. Children presenting to ENT emergency with suspected FB ingestion underwent rigid esophagoscopy and FB removal. Average age, number of attempts, duration of ingestion, success rate, and complications were analysed. RESULTS: Cases of coin/LBBFB ingestion: 916/70. Mean age: 5.8/2.03 years (p < 0.001). Average duration of ingestion: 37/9.5 h (p < 0.001). Patients below 3: 31.3/62.8% (p < 0.001). Suggestive history/radiological signs: 100%/100%, 75.7%/98.6% (p < 0.0001). Site of impaction cricopharynx: 60.3%/74.3% (p = 0.02). LBBFB group: Successful removal in 1st attempt: 66 (94.3%). Cases requiring multiple attempts due to impaction: 4 (5.7%). Parenteral steroids were administered before successful reattempt. No relation was found between duration of ingestion/impaction. Five (7.1%) cases developed complications. Average follow-up duration: 13.59 months. CONCLUSIONS: Children <3 years with vague history of FB ingestion and suggestive chest x-ray should be sent urgently for FB removal. Parenteral pre-and postoperative short course steroid use may be considered to improve outcomes.
OBJECTIVE: To examine sensitivity/specificity of history & radiology to identify ingested foreign body (FB) and develop a protocol for management of ingested FBs in paediatric patients; to assess outcomes of removal of lithium button battery foreign body (LBBFB). METHODS: Retrospective review. Children presenting to ENT emergency with suspected FB ingestion underwent rigid esophagoscopy and FB removal. Average age, number of attempts, duration of ingestion, success rate, and complications were analysed. RESULTS: Cases of coin/LBBFB ingestion: 916/70. Mean age: 5.8/2.03 years (p < 0.001). Average duration of ingestion: 37/9.5 h (p < 0.001). Patients below 3: 31.3/62.8% (p < 0.001). Suggestive history/radiological signs: 100%/100%, 75.7%/98.6% (p < 0.0001). Site of impaction cricopharynx: 60.3%/74.3% (p = 0.02). LBBFB group: Successful removal in 1st attempt: 66 (94.3%). Cases requiring multiple attempts due to impaction: 4 (5.7%). Parenteral steroids were administered before successful reattempt. No relation was found between duration of ingestion/impaction. Five (7.1%) cases developed complications. Average follow-up duration: 13.59 months. CONCLUSIONS:Children <3 years with vague history of FB ingestion and suggestive chest x-ray should be sent urgently for FB removal. Parenteral pre-and postoperative short course steroid use may be considered to improve outcomes.
Authors: Silvia Bisoffi; Francesco Fascetti Leon; Elisa Zambaiti; Alberto Sgrò; Luca Maria Antoniello; Piergiorgio Gamba Journal: Ann Med Surg (Lond) Date: 2021-08-13