ueg education Mistakes in… 2024

Mistakes in paediatric foreign body ingestion and how to avoid them

Raoul I. Furlano, Jorge Amil-Dias, Lissy de Ridder and Christos Tzivinikos

Incidents involving ingestion of foreign bodies and food bolus impactions are relatively
common, primarily in paediatric populations, with a notable peak between the ages of
6 months and 6 years.1, 2 Unfortunately, there are no international European studies on the
incidence of foreign body ingestion in children. Only a few retrospective survey studies exist
on button battery (BB) ingestion.
Labadie et al. documented all instances of BB ingestion in France from 1 January 1999
to 30 June 2015. They revealed an average incidence of 266 ± 98.5 cases per year, with most
patients under 5 years old (65.55%). Within this age group, the median age was 1.91 years
with a roughly equal sex split (2105 (52.2%) males and 1877 (46.6%) females).3
A retrospective nationwide survey of paediatric gastroenterologists and paediatric
surgeons in Germany between 2011 and 2016, identified 116 cases of BBs located in the
oesophagus. This corresponds to 0.1 cases per million people. Children aged 8–12 months
accounted for 18 cases (15%), those aged 13–24 months composed 41 cases (35%), the
25–36 months group constituted 15 cases (13%) and there were 10 cases in children older
than 36 months (9%). The exact ages of the remaining 32 patients were not specified (28%).
BB ingestion was most frequent between 13 and 24 months of age. Oesophageal location
led to severe complications in 47 children, and 5 of these children died as a result.4
Pre-endoscopic studies have demonstrated that in approximately 80% of cases, foreign
objects pass naturally through the digestive tract without medical intervention.1 The
mortality rates associated with these incidents have been remarkably low. A study by
Cheng et al. showed only a single fatality among 1265 children: an 8-year-old girl who was
intellectually disabled ingested a chicken bone that became lodged in her oesophagus.
The bone's presence resulted in erosion of the oesophageal tissue, leading to left pleural
empyema and the formation of a fistula connecting the oesophagus to the left main
bronchus. After removal of the foreign body she died of systemic sepsis.2 A fatality of a
2-year-old boy, reported as a case report, occurred as a result of the formation of an
aorto-oesophageal conduit induced by the impaction of a sharp foreign body in the radiopaque objects, it is important to assess the
oesophagus.5 presence of free air in the mediastinal or
Managing a child who has ingested a foreign object poses a considerable challenge for peritoneal areas.1, 8 Routine contrast studies
the medical team. Several factors come into play when considering whether and when to should be avoided in patients with suspected
intervene, such as the patient's age and size; the ingested item’s size, nature and location high-grade acute oesophageal obstruction due
within the gastrointestinal tract; clinical symptoms; and the time since ingestion. Handling to the risk of aspiration. Additionally, opaque
ingested blunt and sharp foreign bodies can be a delicate and potentially hazardous contrast agents like barium can coat the foreign
procedure. Here, we highlight common errors and potential issues. body and oesophageal mucosa, which can hinder
subsequent endoscopy.1 The use of Gastrografin®
(amidotrizoic acid), a hypertonic non-opaque
Mistake 1 Failing to diagnose promptly expected to be visible on X-rays. However, many contrast agent, should be avoided as it can lead to
and correctly foreign bodies are nonradiopaque, diminishing severe chemical pneumonitis. Similarly, as it is in
the reliability of radiographs.6 Common the case of using barium if aspirated.9
One of the most common errors with ingested radiolucent objects include fish and chicken There is a lack of paediatric studies supporting
foreign bodies is incorrect diagnosis. Patients bones, wood, plastic and slender metal items.1, 6 the use of CT (computed tomography) scans for
or caregivers may not recollect ingestion or the For example, thin aluminium fragments, diagnosing foreign body ingestion. There is
object may not manifest in initial radiological such as pull-tabs from beverage cans, are not also insufficient evidence to justify the use of
imaging studies, causing a delay in diagnosis. For radiopaque.7 Current guidelines recommend metal detectors for locating ingested coins or
the initial diagnosis, radiographs can confirm the promptly referring patients with suspected ultrasonography in children, although a few
location, size, shape and number of ingested foreign body ingestion to the emergency studies in small populations indicated some
foreign bodies, and they can help rule out department for radiographic assessment, even utility.10–12 MRI (magnetic resonance imaging)
aspirated objects.1 if they are asymptomatic. Biplane radiographs is not beneficial in paediatrics because of the
Radiographs are effective in identifying of the neck, chest, abdomen and pelvis should required anaesthesia and should also be avoided
most foreign bodies, particularly if the object is be obtained as needed. In addition to locating with ferromagnetic foreign bodies.13

© UEG 2024 Furlano, Amil-Dias, De Ridder and Tzivinikos
Cite this article as: Furlano RI, Amil-Dias J, De Ridder L and
Tzivinikos C. Mistakes in paediatric foreign body ingestion and how
to avoid them. UEG Education 2024; 24: 1-7.
Raoul I Furlano is Head of Pediatric Gastroenterology & Nutrition,
University Children’s Hospital Basel, Switzerland.
Jorge Amil-Dias is a Pediatric Gastroenterologist at Hospital
Lusiadas, Porto; Retired from Centro Hospitalar Universitário.
S. João, Porto, Portugal. Lissy de Ridder is at the Department of
Paediatric Gastroenterology, Erasmus MC/Sophia Children’s
Hospital, Rotterdam, The Netherlands. Christos Tzivinikos is Head
of Paediatric Gastroenterology Department Al Jalila Children’s
Specialty Hospital, Dubai, United Arab Emirates
Illustrations: J. Shadwell
Correspondence to: raoul.furlano@ukbb.ch
Conflicts of interest: The authors have no conflicts of interest.
Published online: 8 February, 2024.

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ueg education
Recommendations
• We propose early referral to the emergency
department and X-ray evaluation for all
patients with suspected foreign body
ingestion, even if they are asymptomatic.
• Biplane radiographs should be taken of the
neck, chest, abdomen and pelvis, as needed.
Mistake 2 Confusing BBs with coins
Electric current from BBs can hydrolyse tissue
fluids and lead to hydroxide production at the
negative terminal of the BB. This process causes
rapid liquefaction necrosis and severe burns. For
damage to occur, a BB must become lodged or
impacted, allowing sufficient hydroxide to
accumulate at a specific site. The combination of
pressure necrosis and hydroxide can result in
tissue erosion. The oesophagus is particularly
vulnerable due to its weak peristalsis and three
areas of narrowing: (1) the cricopharyngeal
sphincter, (2) where the oesophagus is crossed
by the aortic arch and (3) the lower oesophageal
sphincter. If a BB becomes lodged in the
oesophagus, it has the potential to erode into the
aorta, trachea, lung or mediastinum. Notably,
burns may persist even after BB removal; in one
instance, an aorto-oesophageal fistula (AOF)
was reported 27 days post-removal of the BB.14
Leakage of lithium BB contents does not pose
harm.15 However, in alkaline batteries, hydroxide
can leak out and be produced in the tissue,
leading to tissue damage. It is important to note
that BBs can cause injury without being chewed
or damaged. Even ‘spent’ BBs, unable to power a
gadget, retain a residual voltage that can be
harmful, although new BBs pose the greatest
risk.16 Chiari’s triad characterises the typical
manifestation of AOF with mid-thoracic pain,
sentinel arterial haemorrhage and exsanguination
occurring after a symptom-free interval. In some
instances, unsuspected cases may present with
bright red haematemesis.17 In the United States,
70% of paediatric fatalities were associated with
haematemesis or melaena in the days or hours
leading to the fatal haemorrhage.18
When dealing with a child who has ingested
or is suspected of ingesting a coin or other blunt
foreign body, radiography should be performed as
mentioned above. It is essential to avoid confusing
a coin with a BB. Therefore, a careful examination
of the coin’s edges is necessary to exclude the
double halo sign indicative of a BB (Figure 1).
Lateral X-ray images can also be helpful in
distinguishing between the two. However, it is
important to note that in thinner batteries, the
ring or halo may not be visible.19 Attempts to
differentiate between a coin and a BB based on
the density of a disc-shaped object have been
unsuccessful.20 If the battery is lodged in the
oesophagus, prompt endoscopic extraction is
essential, ideally within 2 hours of ingestion.
2
Double-ring/halo
Figure 1 | On radiographs, BBs have a double-ring or halo appearance (left). In contrast, coins have a
homogenous appearance (right). Adapted from Sethia et al.54
Endoscopy should not be postponed, even if the
patient has recently eaten.8
Recommendations
• We suggest checking for the double halo sign
on radiographs and considering lateral films
to differentiate between coins and BBs.
• If the BB is in the oesophagus, prompt
endoscopic removal is essential, ideally
within 2 hours of ingestion. Endoscopy should
not be postponed, even if the patient has
consumed food.
• In cases where the BB is lodged in the
oesophagus, prompt endoscopic extraction is
imperative and should ideally be performed
within a 2-hour timeframe following
ingestion. Delays in endoscopy are strongly
discouraged, even if the patient has recently
consumed a meal.
Mistake 3 Neglecting mitigation
strategies and monitoring in oesophageal
BB impaction
In instances of oesophageal impaction due to
the ingestion of BBs, the risk of severe harm is
elevated, particularly in children under the age of
5 years and when the BB exceeds a diameter of
20 mm.16 Various strategies for reducing injuries
have emerged in recent years. If the patient’s
condition is stable and ingestion occurred within
the past 12 hours, it is advisable to consider
administering honey (for individuals over 1 year
of age) or sucralfate (1 g/10 mL suspension) while
awaiting endoscopy.21 However, it is crucial to
emphasise that this should never impede the
prompt performance of an endoscopy.22 The
recommended dosage for both substances is
10 mL (equivalent to 2 teaspoons) every 10 min,
with a maximum of six doses for honey and three
doses for sucralfate.21, 23 It is imperative to avoid
cathartics and refrain from inducing vomiting.
These measures are by no means a substitute for
the urgent removal of the BB through endoscopy,
Mistakes in… 2024
ideally within 2 hours of ingestion. If ingestion
extends beyond 12 hours, a CT scan and
consultation with a surgeon should precede
endoscopic removal.
During the removal procedure — be prepared for
immediate complications, such as oesophageal
perforation and tracheo-oesophageal fistula, and
assess the risk of injury based on the proximity to
significant vascular structures, including arterial
fistulas.16, 24 If no visible oesophageal perforation
or fistula is detected, conduct endoscopic
irrigation of the injured tissue site using 50–150 mL
of a sterile acetic acid solution (0.25%) while
simultaneously removing any excess irrigation by
suction.21 If there is evidence of perforation, fistula
or severe circumferential injury, consider inserting
a nasogastric tube (NGT) while in the operating
room with a direct endoscopic view. Do not blindly
insert an NGT or do so on the ward. In cases of
oesophageal BB ingestion, tissue injury can
progress and complications such as bleeding from
a vascular fistula can occur up to 3 weeks after
ingestion.14 Therefore, if severe mucosal injury is
apparent upon removal, it is advisable to order
contrast imaging (MRI, CT angiography) to assess
the proximity of the oesophageal mucosal injury
site to major blood vessels, particularly the aorta.25
Consider performing an oesophagogram before
commencing a clear liquid diet. If this diet is well
tolerated, gradual progression to soft or mashed
foods is recommended, usually for a period of
up to 4 weeks while administering acid-blocking
medications.
Maintain vigilance for potential delayed
complications, which can manifest over
several weeks: oesophageal perforation,
tracheo-oesophageal fistula, AOF, vocal cord
paresis or paralysis, mediastinitis, spondylodiscitis
or oesophageal stricture. Comprehensive discharge
instructions must be provided, with a strong
emphasis on recognising the signs and symptoms
of these potentially delayed complications,
particularly upper gastrointestinal bleeding
arising from a vascular fistula. A concise overview
of the diagnosis and management of BB ingestion
ueg education Mistakes in… 2024

Diagnosis and management

First steps
• Check vital signs and manage if abnormal
• Consult ENT doctor in case of airway obstruction/location
• Consider honey if stable, >1 years and able to swallow and ingestion <12 hours
• Perform 2 view x-ray

Suspected button battery ingestion

Battery in the oesophagus Battery beyond the oesophagus

Diagnosis ≤12 hours >12 hours delay in Diagnosis ≤ 12 hours >12 hours delay in
of ingestion diagnosis/removal of ingestion diagnosis/removal

Consider endoscopy to rule out

• Immediate endoscopic Consider CT and
oesophageal damage and
removal preferably surgical consultation Symptomatic or Asymptomatic CT scan to look for
<2 hours (if at/above prior to endoscopic magnet co-ingestion
level of clavicles direct removal
removal by ENT surgeon)
• Consider if stable, able to Small intestine Small intestine
Stomach or colon Stomach
swallow and ingestion or colon
<12 hours honey(<1 years)
or sucralfate while waiting
for endoscopy (do not Immediate endoscopic Consult Remove during
delay it) removal preferably surgeon endoscopy Symptomatic or Asymptomatic
• Consider 50-150 ml <2 hours magnet co-ingestion
0.25%, acetic acid
irrigation post-removal
if no signs of perforations/ Consult Repeat x-ray after
fistulations surgeon 7-14 days (or sooner
if symptoms develop)
At any stage always consider additional imaging and
surgical consultation when signs of complications occur In no passage,
consult surgeon

Figure 2 | Diagnosis and management of BB ingestion. Adapted from Mubarak A, Benninga MA, Broekaert I et al.55

cases in children can be found in a position
paper from the European Society for Paediatric
Gastroenterology Hepatology and Nutrition
(ESPGHAN) (Figure 2).24
Mistake 4 Delaying intervention
Once a foreign body is suspected or confirmed,
the timing of intervention can be critical. Some
objects may pass through the digestive tract
without causing harm, while others may become
lodged or cause damage relatively quickly.
Delaying intervention can lead to complications.
The timing of endoscopy depends on various
factors, including the patient’s age and clinical
condition, time of last oral intake, type of
ingestion, location of object in the gastrointestinal
tract and time since ingestion. Additionally,
judgment of the risks of aspiration, obstruction or
perforation should guide the timing of endoscopy.
In broad terms, the timing can be classified as
emergent (within 2 hours of presentation,
irrespective of nil by mouth status), urgent
(within 24 hours of presentation) or elective (more
than 24 hours after presentation).8 Most clinically
stable patients without symptoms of high-grade
gastrointestinal obstruction do not require urgent
endoscopy because the ingested object will
usually pass spontaneously, except in the case
of BB ingestion.1, 26, 27 However, children with
oesophageal foreign bodies or food impactions,
even when asymptomatic, should undergo urgent
removal (within 24 hours of presentation) because
delayed removal reduces the likelihood of success
and increases the risk of complications, including
perforation.
These recommendations are based on
studies involving adults due to a lack of
paediatric research.28, 29 Furthermore, in the case
of food impaction, one must always consider the
possibility of eosinophilic oesophagitis as the
cause and exclude it through biopsies, preferably
not at the site of the bolus impaction but above
and below it. However, a recent study showed
that food bolus impaction due to eosinophilic
oesophagitis was significantly more common
among adults than children.30 For foreign bodies
in the stomach with no risk of anatomical
complications in the digestive segments beyond
the stomach, most foreign bodies usually pass
within 4 to 6 days.
Therefore, conservative outpatient
management is suitable for most asymptomatic
gastric foreign bodies, except for BBs.2, 22, 31, 32
However, Lee reported removal within 24 hours
in cases where the ingested foreign bodies were
unlikely to pass through the pylorus (longer
than 6 cm or more than 2.5 cm in diameter).33
If a child with foreign body ingestion is
managed as an outpatient, they should maintain
a regular diet and their parents should monitor
stools for evidence of object passage. Small,
blunt objects, including coins, may take as long
as 5 weeks to pass spontaneously.26, 31 A major
exception to this approach to gastric foreign
body, would be the presence of more than
one magnet in the stomach or duodenum
(see Mistake 6).
Recommendations
• We suggest blunt foreign bodies, coins or
impacted food in the oesophagus should be
removed urgently in asymptomatic children
(within 24 hours). If the child is symptomatic,
emergent removal (within 2 hours) is indicated.
• Removal of blunt foreign bodies from the
stomach or duodenum should be considered if
the child is symptomatic or if the object is large
(greater than 2.5 cm) or long (more than 6 cm).
Otherwise, blunt foreign bodies in the stomach
should be monitored and retrieved only if they
cause symptoms or fail to pass spontaneously
after 4 weeks.

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ueg education Mistakes in… 2024

Mistake 5 Delaying endoscopy when
sharp-pointed objects are not visible on
radiological imaging or do not progress
The frequency and nature of ingested sharp
objects are strongly influenced by cultural and
environmental factors. In Asian and Mediterranean
families, where fish is a staple introduced early
in life, instances of young children ingesting fish
bones are more prevalent.27 Symptoms
commonly arise if the foreign body is lodged in the
upper-mid oesophagus, leading to pain, dysphagia,
odynophagia and drooling. Despite this, a
significant proportion of patients may remain
asymptomatic for weeks, with potential
complications such as delayed intestinal
perforation, extraluminal migration, abscess
formation, peritonitis, fistula formation,
appendicitis and penetration of organs like the
liver, bladder, heart, lungs and even rupture
of the common carotid artery.34–41 The ileocecal
region is the most frequently affected site for
intestinal perforation, although instances have
been documented in the oesophagus, pylorus,
the junction between the first and second part
of the duodenum, and the colon.42 Complication
rates are higher in symptomatic patients, those

a
Initial assessment
• Check vital signs and ensure patient is hemodynamically stable and manage as clinically indicated
• Ensure no signs of obstruction or perforation are present
• Early consultation to gastrogenterology and surgery
• Keep the patient Nill Per Oral in preparation for endoscopy/surgery
• Remove all magnets and metals from patients’ clothes and environment

Patient with suspected/reported

single magnet ingestion
Single magnet ingestion confirmed by
history and X-ray (chest and abdomen)
If a rare earth magnet is ingested with
a button battery this is a CRITICAL
EMERGENCY (refer to ESPGHAN button
battery ingestion position paper 2023)

Red flags at presentation

• Pre-existing conditions (neuromuscular Two view X-ray should be reviewed
condition, GI stricture etc) by radiologist
• Large magnet size (> 6 cm long and/or
> 2 cm wide)
• Signs of obstruction on abdominal X-ray Location
Trachea Stomach
and beyond
Oesophagus

Symptomatic Symptomatic Symptomatic

No Yes Yes No Yes No

• Consult GI Discussion with local Discharge and

• Keep NPO • Urgent removal
and ENT paediatric gastroenterology and repeat abdominal
• Start IV fluids • Consult GI
paediatric surgery services for X-ray every 2-3 days
• Ensure patent airway and ENT
• Admission for observation
• Repeat X-ray in 6 hours
Consider starting • If no progression proceed to Magnet progression is
antibiotics surgical removal confirmed by radiologist
Discharge criteria and patients remains
• Accidental ingestion asymptomatic
• No risk for further ingestion
• Tolerating oral intake • Emergent removal Start patient on
• Caregiver can provide close • Consultation to ENT antibiotics No Yes
observation and GI
Can discharge home
Patient
b on safety net advice
develops
Oesophagus symptoms
Failure of progression and
Second magnet patient remains asymptomatic
swallowed Magnets

Consider specialist input

for observation vs removal

Magnet
in stomach
Magnetic force
pulls intestine to
Magnet in stomach, causing
small intestine damage

Figure 3 | Management of multiple magnets ingested in a child: a | Evaluation and management of a child with multiple magnets ingested. Adapted from Nugud et al.49
b | Magnets can strongly attract each other through multiple layers of bowel/gastric wall. Adapted from Kodituwakku et al.56

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ueg education
with a delay in diagnosis beyond 48 hours, or those
who have ingested radiolucent foreign bodies.43–45
Toothpick and bone ingestions pose a particularly
high risk of perforation and are the most common
types of objects requiring surgical removal.44
Evaluation of patients suspected of
ingesting sharp-pointed objects is crucial to
determine the object’s location. Since many
sharp-pointed objects are not visible on
radiographs, endoscopy should follow a radiologic
examination with negative findings when there is a
high suspicion. Objects lodged in the oesophagus,
especially sharp-pointed ones, constitute a
medical emergency due to the potential for
high-risk complications like perforation and
migration. Direct laryngoscopy is an option for
removing objects lodged at or above the
cricopharyngeus. If laryngoscopy is unsuccessful or
if the object is below this area, flexible endoscopy
may be performed. Sharp-pointed objects in the
stomach or proximal duodenum should also be
removed urgently. If these objects pass through
the duodenum, enteroscopy or surgery may be
considered in symptomatic patients. In
asymptomatic cases where observation is
chosen over immediate removal, monitoring in a
hospital setting with daily abdominal X-rays may
be considered.13 Patients should be instructed to
promptly report symptoms such as abdominal
pain, vomiting, persistent temperature elevation,
haematemesis or melaena.46 The average transit
time for a foreign object ingested by children
is reported as 3.6 days, while the mean time
from ingestion of a sharp object to perforation
is reported as 10.4 days.47, 48 Surgical removal
may be considered if the foreign body has not
progressed on imaging in 3 days or if the patient
becomes symptomatic.47, 48
Recommendations
• In cases of ingested sharp foreign bodies,
endoscopy should be performed even if the
objects are not visible on radiological imaging.6
• Surgical removal of a non-progressing
ingested sharp foreign body (as determined
by radiological imaging) should be
considered after 3 days or if the patient
becomes symptomatic.
Mistake 6 Delaying endoscopy when two
or more magnets or superabsorbent
polymer beads have been ingested
Ingestion of magnets is a unique category of
foreign body ingestion associated with increased
morbidity and mortality, especially when
multiple magnets are ingested sequentially or in
conjunction with other metallic foreign bodies.
Prompt recognition and endoscopic removal are
necessary for neodymium magnets, which exhibit
stronger magnetism, to prevent them from
moving beyond the reach of a gastroscope.49
Once they move beyond this point, continuous
monitoring involving a surgical team is essential,
even if the patient remains asymptomatic, as
magnets can exert strong attractive forces on each
other through multiple layers of the bowel and
gastric wall (Figure 3).
In the case of ingestion of beads or balls
made of superabsorbent polymers, emergent
endoscopic removal (within 2 hours) is
advisable, as these can potentially lead to fatal
bowel obstruction in children secondary to rapid
increase in bead size within the intestinal tract
(Figure 4). For patients in whom ingestion is
suspected but not witnessed, the decision to
proceed with endoscopy may be taken even prior
to the onset of clinical symptoms, contingent upon
the degree of suspicion. If upper endoscopy fails
to identify the object, distal bowel obstruction
should be avoided by close monitoring with the
involvement of a surgical team.34
Recommendations
• We suggest in cases of ingestion of multiple
magnets, especially neodymium magnets,
early recognition and endoscopic removal are
essential. Continuous monitoring is necessary
if the magnets move beyond the reach of a
gastroscope.
• In cases of suspected ingestion of
superabsorbent polymer beads, emergent
endoscopic removal (within 2 hours) is
advised to prevent potential bowel
obstruction. Continuous vigilance and
surgical consultation are necessary if the
object is not initially identified with an upper
endoscopy.
Step 1
Figure 4 | Proposed mechanism of superabsorbent polymer bead-induced bowel obstruction in children.
Adapted from W. Care et al.57
Mistakes in… 2024
Mistake 7 Attempting endoscopic removal
of packets containing drugs
In regions with high drug trafficking, the
practice of ‘body packing’ can also involve
children and teenagers. Illegal drugs are
concealed in latex condoms, balloons or plastic
and swallowed for transportation.50, 51 If there
is a risk of leakage or rupture of these packets,
endoscopic removal should not be attempted.
Surgical intervention is necessary when the
packets do not progress or when signs of
intestinal obstruction are present. In cases
where packet rupture is suspected, surgery and
urgent medical assessments for drug toxicity are
warranted.8
Recommendation
• Endoscopic removal of packets containing
drugs ingested by children and teenagers
should not be performed.
Mistake 8 Routinely using rigid
oesophagoscopy for oesophageal foreign
body retrieval
Both rigid and flexible endoscopic approaches
seem to demonstrate comparable safety and
efficacy in the extraction of oesophageal foreign
bodies. However, the use of flexible endoscopy
for oesophageal foreign body removal requires
significantly less time than rigid endoscopy.
Flexible endoscopy is likely to enable a more
comprehensive examination, including the
possibility of obtaining biopsies of the
oesophageal mucosa, in comparison to rigid
Step 2 Step 3
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ueg education
endoscopy.52 One study has indicated that
rigid oesophagoscopy carries a higher
complication rate when used for oesophageal
foreign body extraction. Complications in the
study of Berggreen et al. included two cases of
post-procedure fever and two cases of extended
respiratory depression. Therefore, it should be
reserved for proximally located blunt objects,
and its routine use is discouraged.53
Recommendation
• Rigid oesophagoscopy should not be used
routinely for oesophageal foreign body
retrieval in children.
References
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Banerjee S, Ben-Menachem T, et al. Management of
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2. Cheng W, Tam PKH. Foreign-body ingestion in
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54. Sethia R, Gibbs H, Jacobs IN, Reilly JS, Rhoades K,
Jatana KR. Current management of button battery
injuries. Laryngosc Investig Otolaryngol 2021; 6 (3):
549–563.
55. Mubarak A, Benninga MA, Broekaert I, Dolinsek J,
Homan M, Mas E, et al. Diagnosis, Management, and
Prevention of Button Battery Ingestion in Childhood:
A European Society for Paediatric Gastroenterology
Hepatology and Nutrition Position Paper. J Pediatr
ueg education
Gastroenterol Nutr 2021; 73 (1): 129–136.
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Your paediatric foreign body ingestion briefing
UEG week
• ‘European society of paediatric gastroenterology
hepatology and nutrition (ESPGHAN) button battery
ingestion taskforce survey across Europe and beyond
– iceberg below the surface.’ – poster at ueg week
2023. [https://ueg.eu/library/european-society-of-
paediatric-gastroenterology-hepatology-and-nutri-
tion-espghan-button-battery-ingestion-taskforce-sur-
vey-across-europe-and-beyond-iceberg-below-the-
surface/d1b173ae-743c-11ee-8565-0242ac140004]
• ‘A UK based retrospective analysis of the
management of patients presenting as an emergency
with foreign body in the oesophagus.’ – Poster at
UEG week 2023. [https://ueg.eu/
library/a-uk-based-retrospective-analysis-of-the-man-
agement-of-patients-presenting-as-an-emergency-
with-foreign-body-in-the-oesophagus/4e2a4a7e-
743c-11ee-9d0f-0242ac140004]
• ‘Foreign body removal and bougienage.’ – Session at
UEG Week 2023. [https://ueg.eu/library/foreign-body-
removal-and-bougienage/
d8c03362-74da-11ee-8ace-0242ac140004]
Standards and Guidelines
• Birk M, Bauerfeind P, Deprez PH, Häfner M,
Hartmann D, Hassan C, et al. Removal of foreign
bodies in the upper gastrointestinal tract in adults:
European Society of Gastrointestinal Endoscopy
(ESGE) Clinical Guideline. Endoscopy 2016 ;
48 (5): 489–496. [https://ueg.eu/library/
removal-of-foreign-bodies-in-the-upper-gastrointes-
Mistakes in… 2024
57. Caré W, Dufayet L, Paret N, Manel J, Laborde-
Casterot H, Blanc-Brisset I, et al. Bowel obstruction
following ingestion of superabsorbent polymers
beads: literature review. Clin Toxicol 2022; 60
(2):159–167.
tinal-tract-in-adults-european-society-of-gastrointes-
tinal-endoscopy-esge-clinical-guideline/
df441ef8-9360-11ed-b668-0242ac140004]
• Thomson M, Tringali A, Dumonceau JM, Tavares M,
Tabbers MM, Furlano R, et al. Paediatric Gastrointestinal
Endoscopy: European Society for Paediatric
Gastroenterology Hepatology and Nutrition and
European Society of Gastrointestinal Endoscopy
Guidelines. J Pediatr Gastroenterol Nutr 2017; 6 (1):
133–153. [https://ueg.eu/library/paediatric-gastrointes-
tinal-endoscopy-european-society-for-paediatric-gas-
troenterology-hepatology-and-nutrition-and-euro-
pean-society-of-gastrointestinal-endoscopy-guidelines/
e14c6278-9360-11ed-847e-0242ac140004]
• Nugud AA, Tzivinikos C, Assa A, Borrelli O, Broekaert I,
Martin-de-Carpi J, et al. Pediatric Magnet Ingestion,
Diagnosis, Management, and Prevention: A European
Society for Paediatric Gastroenterology Hepatology
and Nutrition (ESPGHAN) Position Paper. J Pediatr
Gastroenterol Nutr 2023;76 (4): 523–532. [https://
journals.lww.com/jpgn/fulltext/2023/04000/
pediatric_magnet_ingestion,_diagnosis,_
management,.26.aspx]
• Mubarak A, Benninga MA, Broekaert I, Dolinsek J, Homan
M, Mas E, et al. Diagnosis, Management, and Prevention
of Button Battery Ingestion in Childhood: A European
Society for Paediatric Gastroenterology Hepatology and
Nutrition Position Paper. J Pediatr Gastroenterol Nutr
2021 ;73 (1): 129–136. [https://onlinelibrary.wiley.com/
doi/10.1097/MPG.0000000000003048]