Imaging characteristics of gastrointestinal foreign bodies in children and analysis of risk factors associated with the severity of complications.

Objective: To analyze the clinical characteristics, imaging findings, and risk factors for complications of gastrointestinal foreign bodies in children, and to provide evidence for clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on 78 foreign body retention sites in 71 pediatric patients diagnosed with gastrointestinal foreign bodies in a hospital from August 2020 to December 2025. Data including demographic characteristics, types of foreign bodies, imaging findings, complications, and treatment methods were collected. Foreign bodies were classified into six categories. Retention time was defined as the interval from the confirmed or most suspected time of ingestion to the time of imaging examination. Interobserver agreement for ultrasound interpretation was assessed using Cohen's Results: Among 71 children, 57.7% were male; median age 3 years. Magnetic beads were most common (54.9%), followed by coins (12.7%) and water-absorbing beads (8.5%). The small intestine was the main impaction site (41.5%). Complications occurred in 50 patients (70.4%): perforation in 32 (45.1%) and obstruction in 26 (36.6%). Magnetic beads caused perforation in 71.8%; water beads caused obstruction in 100%. Ultrasound effectively detected radiolucent foreign bodies, whereas plain radiography did not. Independent risk factors for complications included sharp/corrosive foreign bodies (OR = 5.12), retention time >24 h (OR = 4.87), upper gastrointestinal location (OR = 3.21), and symptomatic presentation (OR = 3.94) (all Conclusion: Magnetic beads are the most common and high-risk gastrointestinal foreign bodies in children. Ultrasound is valuable for detecting radiolucent objects. Retention time >24 h, upper gastrointestinal location, and symptoms warrant early intervention.