Ingestie van corpora aliena op de kinderleeftijd

Objective. Foreign body (FB) ingestion is a common paediatric problem. Although ingestion usually does not require intervention, complications are reported. Design. Retrospective analysis. Methods. We analysed data from children presenting after FB ingestion at our pediatric department (Emma Kinderziekenhuis; Academic Medical Center, Amsterdam) between 1981-2008. Data extracted included age, gender, nature of FB, location, symptoms, investigations, interventions, complications/mortality. We compared our results with the literature. Results. A total of 113 patients were analysed (68% boys), aged 7 months to 17 years (median: 3,6 years). Nineteen patients (17%) suffered from an underlying disease: oesophagus atresia (12), eosinophilic oesophagitis (2), peptic stenosis (1) and mental retardation (4). Coins (46%) were the most ingested FB. At presentation 41% of the FB's were located in the stomach, 19% in the proximal oesophagus, 14% mid oesophageal and 9% in the distal oesophagus. In 17% of the cases the FB had passed the pylorus. No symptoms were found in 51% of the patients at presentation. Common symptoms were retrosternal pain (16%), vomiting (13%), excessive saliva production (8%), food refusal (7%) and respiratory symptoms (4%). Upper endoscopy was performed in 97/113 (86%) of the cases, 26% had erosions/ulcerations and 2% perforations of the oesophagus. In 70% no abnormalities were seen. There was no mortality. Conclusions. Rapid endoscopic removal is indicated if the FB does not pass the oesophagus spontaneously. Endoscopic abnormalities were seen in only 30% of the cases, and were more severe if the FB was ingested weeks ago. Our data support a 'wait and observe' policy in case the FB passed the oesophagus.