Published online Sep 9, 2023. doi: 10.5409/wjcp.v12.i4.205
Peer-review started: April 28, 2023
First decision: May 25, 2023
Revised: June 9, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: September 9, 2023
Accidental ingestion of foreign bodies (FBs) or harmful materials is a common problem in families with children because of their exploratory behavior. This behavior puts them at risk and can cause serious morbidities.
While many studies on accidental ingestion in children have been published from several countries worldwide, no study has been published on this issue in Bahrain. This knowledge gap motivated us to study this health problem in Bahrain.
To evaluate the incidence, demographics, types of FBs/harmful materials ingested, diagnostic methods, management, complications, and outcomes of accidental ingestion in pediatric patients at the main tertiary hospital in Bahrain and compare patients with endoscopic or surgical complications with those without to identify the predicted risk factors.
We retrospectively reviewed and collected the demographic data, clinical presentations, radiological and endoscopic findings, treatments, complications, and outcomes of accidental ingestions in children admitted to the Department of Pediatrics at the Salmaniya Medical Complex, Kingdom of Bahrain, from medical records between 2011 and 2021.
In total, 161 accidental ingestion episodes were documented in 153 children. Male predominance was noted (n = 85, 55.6%). The median age at presentation was 2.8 (interquartile range: 1.8-4.4) years. Most participants ingested FBs (n = 108, 70.6%), followed by caustic chemicals (n = 31, 20.3%) or medications (n = 14, 9.2%). Most patients were symptomatic (n = 86, 57.3%); vomiting was the common symptom (n = 44, 29.3%), followed by abdominal pain (n = 25, 16.7%). Batteries were the most commonly ingested FBs (n = 49, 32%). Unsafe toys were the main source of batteries (n = 22/43, 51.2%). Most episodes occurred while playing (n = 49/131, 37.4%) or unwitnessed (n = 78, 57.4%). Stomach was the common location of FB lodgment, both radiologically (n = 54/123, 43.9%) and endoscopically (n = 31/91, 34%). Of 107/108 (99.1%) patients with FB ingestions, spontaneous passage was noted in 54 (35.5%), endoscopic removal in 46 (30.3%), laparotomy in 5 (3.3%), and direct laryngoscopy in 2 (1.3%). Pharmacological therapy was required in 105 (70.9%) patients. Complications were detected in 39 (26.4%) patients, five of whom had gastrointestinal perforation. Patients who ingested FBs before the age of one year (P = 0.042), those with middle or low socioeconomic status (P = 0.028), and those with more symptoms at presentation (P = 0.027) had more complications.
Accidental ingestion in children is a serious health problem. Symptomatic infants from families with middle or low families have the highest morbidity. Prevention through parental education and government legislation is crucial.
Additional research is required to evaluate the influence of parental awareness, authority regulations, and the provision of safe environments to prevent such serious incidents.