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      Foreign body injuries in children: a review Translated title: Lesioni da corpo estraneo nei bambini: una revisione

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          SUMMARY

          The aim of this paper was to overview existing knowledge on foreign body (FB) injuries in children, with particular focus on FB types and anatomical locations, clinical presentation and complications. FB injuries represent a severe public health problem in childhood. The fact that the highest prevalence of FB injuries is reported for children between 0 and 3 years of age depends primarily on the fact that they explore objects using their mouth and are also not able to distinguish edible objects from non-edible ones. Types of FB causing injuries depend on the symptoms related to FB ingestion/inhalation/insertion (providing an early diagnosis of FB injuries) and complications related to the FB characteristics (type, shape, dimensions). The analysis of the Susy Safe database showed that in 10,564 cases, in which the object type was available, 74% of objects were inorganic and were mostly represented by pearls and balls, followed by coins. The main concerning about FB injuries is the fact that they may be asymptomatic or that symptoms may be non-specific. Consequently, the FB injury can be misinterpreted as a gastrointestinal or respiratory infection. The absence of specific symptoms indicating the occurrence of FB injury can lead to delays in diagnosis, thereby increasing the risk of complications. Symptoms seem to mostly depend on the anatomical location. Many ingested FBs pass naturally through the gastrointestinal tract without complications or damage. However, severe complications can occur depending on the characteristics of the FB, its anatomical location, the child's age and delays in diagnosis.

          RIASSUNTO

          Nel presente lavoro gli Autori sintetizzano le testimonianze relative ai danni provocati da corpi estranei in bambini sottolineandone il tipo, la sede la clinica e le complicanze. I danni provocati da corpi estranei rappresentano un importante e frequente problema di salute pubblica specie nell'infanzia, in quanto i piccoli tra 0 e 3 anni di età hanno l'abitudine di esplorare oggetti sconosciuti portandoli in bocca senza riconoscere se gli stessi sono commestibili o no. L'analisi effettuata nell'ambito del progetto "Susy database" ha permesso di rilevare come nei 10.564 casi esaminati il 74% di oggetti erano inorganici (principalmente perle e palline di ogni genere, seguite da monete). Nella maggior parte dei casi i piccoli non presentavano particolare sintomatologia ovvero sintomi assolutamente non specifici tale da non evidenziarne la causa. L'assenza di specifici sintomi porta generalmente a dilazioni nella diagnosi, aumentando il rischio di complicanze. I sintomi dipendono in massima parte dall'ubicazione e dalla dimensione dell'oggetto inalato ovvero ingerito che può passare attraverso il tratto di gastrointestinale, senza danni. Comunque, è da sottolineare come le complicazioni più importanti sono relative alle caratteristiche del corpo estraneo alle quali bisogna rivolgere particolare attenzione per la scelta terapeutica.

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          Most cited references31

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          Preventing battery ingestions: an analysis of 8648 cases.

          Outcomes of pediatric button battery ingestions have worsened substantially, predominantly related to the emergence of the 20-mm-diameter lithium cell as a common power source for household products. Button batteries lodged in the esophagus can cause severe tissue damage in just 2 hours, with delayed complications such as esophageal perforation, tracheoesophageal fistulas, exsanguination after fistulization into a major blood vessel, esophageal strictures, and vocal cord paralysis. Thirteen deaths have been reported. The objective of this study was to explore button battery ingestion scenarios to formulate prevention strategies. A total of 8648 battery ingestions that were reported to the National Battery Ingestion Hotline were analyzed. Batteries that were ingested by children who were younger than 6 years were most often obtained directly from a product (61.8%), were loose (29.8%), or were obtained from battery packaging (8.2%). Of young children who ingested the most hazardous battery, the 20-mm lithium cell, 37.3% were intended for remote controls. Adults most often ingested batteries that were sitting out, loose, or discarded (80.8%); obtained directly from a product (4.2%); obtained from battery packaging (3.0%); or swallowed within a hearing aid (12.1%). Batteries that were intended for hearing aids were implicated in 36.3% of ingestions. Batteries were mistaken for pills in 15.5% of ingestions, mostly by older adults. Parents and child care providers should be taught to prevent battery ingestions. Because 61.8% of batteries that were ingested by children were obtained from products, manufacturers should redesign household products to secure the battery compartment, possibly requiring a tool to open it.
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            A systematic review of paediatric foreign body ingestion: presentation, complications, and management.

            Foreign body ingestion is a common problem among paediatric populations. A variety of foreign bodies are ingested, some of which are particularly harmful and life threatening such as button batteries, magnets and bones. Common household items such as small toys, marbles, batteries and erasers are often ingested. The aim of this systematic review is to study the problem of foreign body ingestion among paediatric populations in terms of commonly ingested objects, and attempt to identify the link between location of impaction, associated symptoms, complications, spontaneous passage, methods and timing of removal.
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              Foreign bodies in the airways: a meta-analysis of published papers.

              Very recently, some attempts have been made to start a systematic collection of foreign bodies (FB) in view of using them to characterize the risk of chocking in terms of size, shape and consistency of the FB. However, most of the epidemiologic evidence on foreign bodies in children comes from single-center retrospective studies, without any systematic geographical and temporal coverage. This paper is aimed at providing an estimate of the distribution of foreign body's injuries in children according to gender, age, type of FB, site of obstruction, clinical presentation, diagnostic/therapeutic procedures, complications, as emerging from a meta-analytic review of published papers.
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                Author and article information

                Journal
                Acta Otorhinolaryngol Ital
                Acta Otorhinolaryngol Ital
                Pacini
                Acta Otorhinolaryngologica Italica
                Pacini Editore SpA
                0392-100X
                1827-675X
                October 2015
                : 35
                : 4
                : 265-271
                Affiliations
                [1 ] ENT Clinic University of Siena, Italy;
                [2 ] Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Italy;
                [3 ] ENT Clinic Università di Roma Tor Vergata, Rome, Italy
                Author notes
                Address for correspondence: Desiderio Passali, ENT Clinic University of Siena, viale Bracci 33, 53100 Siena Italy. E-mail: d.passali@ 123456virgilio.it
                Article
                Pacini
                4731891
                26824213
                7f8506e2-8e4f-46c3-b049-5c019b8db8e2
                © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/

                History
                : 24 May 2015
                : 18 June 2015
                Categories
                Pediatric Otorhinolaryngology

                Otolaryngology
                foreign bodies,suffocation,children,emergency care
                Otolaryngology
                foreign bodies, suffocation, children, emergency care

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