Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2023; 12(4): 205-219
Published online Sep 9, 2023. doi: 10.5409/wjcp.v12.i4.205
Accidental ingestion of foreign bodies/harmful materials in children from Bahrain: A retrospective cohort study
Hasan M Isa, Shaikha A Aldoseri, Aysha S Abduljabbar, Khaled A Alsulaiti
Hasan M Isa, Shaikha A Aldoseri, Aysha S Abduljabbar, Department of Pediatrics, Salmaniya Medical Complex, Manama 26671, Bahrain
Hasan M Isa, Department of Pediatrics, Arabian Gulf University, Manama 26671, Bahrain
Khaled A Alsulaiti, Department of Radiology, Salmaniya Medical Complex, Manama 26671, Bahrain
Author contributions: Isa HM was the main contributor in study conceptualization, data curation, formal analysis, investigation, methodology, project administration, resources, software, supervision, validation, visualization, original draft writing, and manuscript review and editing; Aldoseri SA, Abduljabbar AS, and Alsulaiti KA were responsible for literature review, data collection, and manuscript drafting and revision; and all the authors have read and approved the final manuscript.
Institutional review board statement: This study was conducted in accordance with the principles of the Declaration of Helsinki, and it was ethically approved by the Secondary Health Care Research Committee, Salmaniya Medical Complex, Government Hospitals, Kingdom of Bahrain (IRB number: 88300719, July 30, 2019).
Informed consent statement: Consent was not needed as the study was retrospective without exposure to the patients’ data.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Data are available upon reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hasan M Isa, MBChB, Associate Professor, Consultant Physician-Scientist, Department of Pediatrics, Salmaniya Medical Complex, 2904, Manama 26671, Bahrain.
Received: April 28, 2023
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
Research background

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.

Research motivation

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.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

Additional research is required to evaluate the influence of parental awareness, authority regulations, and the provision of safe environments to prevent such serious incidents.