ArticleIntestinal Failure (New York, N.Y.)
Gastrointestinal foreign body removal in children with intestinal failure: A single center ten-year retrospective review
Article in Intestinal Failure (New York, N.Y.). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The significance of foreign body (FB) ingestion in children with Intestinal Failure (IF) is unknown. We aimed to characterize differences in procedural management and clinical outcomes related to gastrointestinal FB removal in pediatric patients with IF compared to children without this condition. Material and Methods: This ten-year retrospective review utilized electronic healthcare data from a single pediatric center. We evaluated patients who underwent post-esophageal gastrointestinal FB removal procedures between 2011 and 2020 and compared medical history, presentation, procedure type, and procedure outcomes in children with and without IF. Results: There were 12 patients with IF and 185 controls. All FBs ingested by IF patients carried low intrinsic risk of perforation or obstruction. Esophagogastroduodenoscopy (EGD) was the most common removal procedure in both groups. Patients with IF were more likely to have FBs removed from a post-pyloric location (100 vs. 20.5 %, p < 0.0001), require lower endoscopy (41.7 vs. 9.7 %, p = 0.006), require multiple procedures for definitive removal (41.7 vs. 8.6 %, p = 0.0041), involve > 1 endoscopist or pediatric surgeon (66.7 vs. 7.0 %, p < 0.0001), and require hospital admission (83.3 vs. 28.6 %, p < 0.0001). Conclusion: FB ingestion by children with IF is associated with increased risk of procedural complexity and hospital admission, even when the object's intrinsic risk of gastrointestinal hazard is low. These differences may be related to altered intestinal anatomy and dysmotility. Physicians should consider involvement of an advanced proceduralist during removal. Education to prevent ingestion should be part of routine IF care.
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