BACKGROUND AND OBJECTIVE

Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

This retrospective cohort study included 145 patients agedRESULTS

Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age 48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (CONCLUSION

Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.

Objective:To explore the feasibility of using self-made visual throat forceps to remove hypopharyngeal foreign bodies. Methods:The throat forceps were combined with the endoscope and connected to a monitor via a data cable resulting in a visual throat forceps apparatus. This device was utilized to examine and treat the hypopharyngeal foreign bodies. Results:Among 53 patients, foreign bodies were detected in 51,with 48 cases involving hypopharyngeal foreign bodies. All were successfully extracted using the visual throat forceps. Three cases, diagnosed as esophageal foreign bodies by electronic gastroscopy, were treated using the same method. Conclusion:Visual throat forceps can be used to examine the hypopharynx and remove foreign bodies. It has the advantages of simple operation, rapid operation, and high success rate of foreign body removal from the hypopharynx. It is worthy of clinical application.
Humans ; Hypopharynx/surgery* ; Pharynx/surgery* ; Endoscopes ; Surgical Instruments ; Foreign Bodies/diagnosis*

Objectives: To provide a guide to estimate the location of coins within the esophagus based on the pre-operative radiographic image among pediatric patients seen at the East Avenue Medical Center Department of Otorhinolaryngology – Head and Neck Surgery (ORL-HNS) between January 2018 and December 2020. : Methods Design: Retrospective Case Series Setting: Tertiary Government Training Hospital Participants: The records of 99 pediatric patients aged 6 months to 13 years who were diagnosed with esophageal foreign body (coin) impaction and underwent rigid esophagoscopy from January 2018 to December 2020 were retrospectively reviewed. Results: A predictive model was derived from the data using linear regression analysis. The model shows that we can predict the intraoperative location of coin within the esophagus if provided with the patient’s age and vertebral level of the coin on chest radiograph. Prediction values were reported for patients in three age categories (less than 3 years old, 3 to 7 years old, 8 to 13 years old), at 10 radiographic locations (C2, C4, C5, C6, C7, T1, T2, T3, T7, T8), except for these (C1, C3, T4-T6) because of lack of data. For example, the table predicts that a coin will be located 13 cm (or between 11.4cm to 14.8cm) from the central maxillary incisors (CMI) intraoperatively if the coin was located at level C6 vertebrae on chest radiograph, for patients less than 3 years old. Conclusion This study provides a novel guide that may serve as a practical tool for ENT surgeons to estimate the intraoperative location of coin foreign bodies in the esophagus of pediatric patients based on preoperative radiographic imaging.
Foreign Bodies ; Foreign Bodies ; Esophagus ; Esophagoscopes ; Esophagoscopic Surgery ; Esophagoscopic Surgical Procedures ; Esophagoscopy

Objective: This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes. Methods: Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies Results: Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (<19 years) and 93 (31%) the adult population. The most common foreign bodies reported were coins (63.5%), food (18.1%), and dentures (11.5%). Most esophageal foreign bodies (244/291; 83%) were seen at the cricopharyngeal level in all age groups. The foreign body was removed successfully in 288/291 (98%) of ingestion cases. All 13 cases of foreign body aspiration were successfully removed by bronchoscopy. All patients were discharged improved. Conclusion Most upper aerodigestive tract foreign bodies involved the pediatric age group. Predisposing conditions were mainly due to accidental ingestion and aspiration while playing in the pediatric population and negligence in eating among adults. Almost all ingestion cases were successfully treated with esophagoscopy, while all aspirations were treated successfully with bronchoscopy. Most intraoperative and postoperative complications who were managed conservatively by observation, although some cases required referral to other surgical departments and were treated surgically. All patients were discharged improved.
Foreign Bodies ; Eating ; Esophagoscopy ; Bronchoscopy

Chest pain is one of the most common complaints in the emergency department. Diseases of the heart, aorta, lungs, esophagus, stomach, mediastinum, pleura, and abdominal viscera can all cause chest discomfort (Gulati et al., 2021; Jiao et al., 2021; Lu et al., 2022). Clinicians in the emergency department are expected to immediately recognize life-threatening chest pain (Jiao et al., 2021). Delayed diagnosis further increases the risk of complications and mortality (Liu et al., 2021). In this case, we present an elderly Chinese female who had a history of myocardial infarction two years previously, with chest pain eventually found to be caused by ingestion of a duck bone.
Humans ; Female ; Aged ; Esophagus ; Foreign Bodies/diagnosis* ; Chest Pain/complications* ; Emergency Service, Hospital ; Heart

Foreign body reactions induced by macrophages often cause delay or failure of wound healing in the application of tissue engineering scaffolds. This study explores the application of nanosilver (NAg) to reduce foreign body reactions during scaffold transplantation. An NAg hybrid collagen-chitosan scaffold (NAg-CCS) was prepared using the freeze-drying method. The NAg-CCS was implanted on the back of rats to evaluate the effects on foreign body reactions. Skin tissue samples were collected for histological and immunological evaluation at variable intervals. Miniature pigs were used to assess the effects of NAg on skin wound healing. The wounds were photographed, and tissue samples were collected for molecular biological analysis at different time points post-transplantation. NAg-CCS has a porous structure and the results showed that it could release NAg constantly for two weeks. The NAg-CCS group rarely developed a foreign body reaction, while the blank-CCS group showed granulomas or necrosis in the subcutaneous grafting experiment. Both matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were reduced significantly in the NAg-CCS group. The NAg-CCS group had higher interleukin (IL)-10 and lower IL-6 than the blank CCS group. In the wound healing study, M1 macrophage activation and inflammatory-related proteins (inducible nitric oxide synthase (iNOS), IL-6, and interferon-‍γ (IFN-‍γ)) were inhibited by NAg. In contrast, M2 macrophage activation and proinflammatory proteins (arginase-1, major histocompatibility complex-II (MHC-II), and found in inflammatory zone-1 (FIZZ-1)) were promoted, and this was responsible for suppressing the foreign body responses and accelerating wound healing. In conclusion, dermal scaffolds containing NAg suppressed the foreign body reaction by regulating macrophages and the expression of inflammatory cytokines, thereby promoting wound healing.
Animals ; Rats ; Swine ; Interleukin-6 ; Macrophage Activation ; Tissue Inhibitor of Metalloproteinase-1 ; Wound Healing ; Foreign-Body Reaction ; Foreign Bodies ; Chitosan

Child ; Humans ; Infant ; Esophagus ; Electric Power Supplies ; Eating ; Foreign Bodies

Objective: To analyze the clinical characteristics and complications of esophageal foreign bodies of button battery ingestion in children. Methods: A retrospective descriptive study included 83 children who were hospitalized in our hospital on account of button battery ingestion from January 2011 to December 2021. There were 50 males (60.2%) and 33 females (39.8%). The age ranged from 7.6 months to one month off 10 years, with a median age of 18 months. The data of patient demographics and time from ingestion to admission, location, symptoms, management, complications, and follow-up outcome were recorded. SPSS17.0 software was used for statistical analysis. Results: Seventy-two children (86.7%) were younger than 3 years old. The time from ingestion to admission ranged from 1 h to 2 months, with a median time of 8 h. Among the 63 children who were first diagnosed in our hospital, the most common clinical symptoms were nausea and vomiting (32 cases, 50.8%), dysphagia (31 cases, 49.2%), salivation (11 cases, 17.5%) and fever (10 cases, 15.9%). Seventy-three of 83 cases had complete preoperative diagnostic tests, and 55 cases (75.3%) were diagnosed by X-ray. In 56 cases (76.7%), the foreign badies were impacted in the upper third of esophagus. In 72 cases (86.7%), the foreign badies were removed by rigid esophagoscopy. 23 (27.7%) had serious complications, including tracheoesophageal fistula in 15 cases(TEF;65.2%), vocal cord paralysis (VCP;34.8%) in 8 cases, esophageal perforation in 3 cases (EP;13.0%), hemorrhage in 3 cases(13.0%), mediastinitis in 3 cases (13%), and periesophageal abscess in 1 case (4.3%). There were significant differences in the exposure time of foreign bodies and unwitnessed ingestion by guardians in the complications group (P<0.05). 2 cases died (2.4%)respectively due to arterial esophageal fistula bleeding and respiratory failure caused by stent displacement during the treatment of tracheoesophageal fistula. Conclusion: Accidental button battery ingestion can be life-threatening. and it mostly happens in children under 3 years old. Serious complications may happen cause of non-specific clinical manifestations and unwitnessed ingestions. Anterior and lateral chest X-ray is the first examination choice. Tracheoesophageal fistula is the most common serious complication.
Male ; Female ; Child ; Humans ; Infant ; Child, Preschool ; Tracheoesophageal Fistula/etiology* ; Retrospective Studies ; Foreign Bodies/diagnosis* ; Eating

Penetrating injuries to the hand are common occurrence in the casualty. Careless removal of the penetrating foreign body potentially leads to retained fragments and infection. In diabetic patients, presentation might be delayed due to poor immune response and peripheral neuropathy leading to complications such as spread of infection and amputation. Detecting retained radiolucent foreign body when the entry wound has healed may pose a challenge. We present a case of retained pieces of wood in the first webspace of the hand which presents with infection distant from the healed entry site.
Foreign Bodies

Esophageal Perforation/etiology* ; Esophagus ; Foreign Bodies/complications* ; Humans ; Magnetic Phenomena ; Mediastinum