Endoscopic Removal of Foreign Bodies in Upper GI Tract in Children

ABSTRACT

PURPOSE: The foreing bodies in the upper GI tract are chiefly caused by accidental swallowing and rarely provoke symptoms. It is recommended to remove the foreign bodies if they produce symptoms or remain in GI tract for long duration or complications are expected to bring about. Nowadays the development of pediatric therapeutic endoscopy enables the removal of the foreign bodies in upper GI tract easily. METHODS: A clinical study of 30 cases of pediatric patients with the foreign bodies in the upper gastrointesinal tract diagnosed by the endoscopy at Seoul Red Cross hospital from January 1991 to December 1995 was perforemed. RESULTS: 1) The ages ranged from 1 year to 9 years and the male to female ratio was 2.3:1. 2) The types of ingested foreign bodies were coins (63.3%), audiokeys (10.0%), plastic toy (3.3%), earphone cap (3.3%), metal (3.3%), screw (3.3%), and battery (3.3%). Eighteen cases (60.0%) were located in the 1st narrowing part of the esophagus and 10 cases (33.3%) were in the stomach 3) Presenting symptoms were asymptomatic in 46.7%, dysphagia in 20.0%, vomiting in 16.7%, sore throat in 10.0%, and poor oral intake in 10.0%. The most common symptom in the cases of gastric foreign bodies was asymptomatic (90%), and common symptoms in the cases of 1st esophageal foreign bodies were dysphagia (33.3%), vomiting (27.8%) and asymptomatic (27.8%). 4) Abnormal endoscopic findings were erosive gastritis (16.7%), erosive esophagitis (6.7%), esophageal ulcer (3.3%), esophagitis (3.3%), and pharyngeal necrosis (3.3%) in order. CONCLUSIONS: The upper GI endoscope is a safe and essential method to diagnose and treat foreign bodies in the upper GI tract in pediatric patients.