Ingested foreign bodies in the paediatric patient

Background Paediatric foreign body (FB) ingestion is a common problem and w hile most can be managed conservatively, a sub-population require intervent ion. Aims To establish clear guidelines for management of paediatric FB ingestio n. Methods A retrospective chart review analysing all paediatric admissions wi th FB ingestion over a 10-year period from 1990 to 1999. Results Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0 % of patients. The reasons for admission were as follows: large FBs; danger ous FBs; and living far from the hospital. Nineteen patients (32.2%) were d ischarged without intervention. Thirty-seven (62.7%) required endoscopic re trieval. In two, the FB was not identified at endoscopy. Only three (5%) re quired surgery. Conclusion Conservative management of FB ingestion in the paediatric popula tion is possible in the majority of cases. However, a minority require inte rvention. While guidelines for intervention are ill-defined, definitive ind ications include symptomatic patients, or dangerous objects.