Flexible Endoscopic Management of Foreign Body Ingestion in Children: A Ten-Year Single-Center Retrospective Study in the Philippines

Abstract

Background and Objective. Foreign body (FB) ingestion is a common pediatric concern in the Philippines, but local studies on flexible endoscopic management are lacking. This study aimed to describe the clinical profile and outcomes of children referred for flexible endoscopic management and identify factors associated with poor outcomes.

Methods. This retrospective cohort study included 145 patients aged <18 years admitted to the Philippine General Hospital for FB ingestion from 2014 to 2024. Data on clinical features and outcomes were analyzed, and odds ratios (OR) were calculated to identify associations with poor outcomes, defined as complications or mortality.

Results. Most FB ingestions (96.55%) were accidental, with coins as the most common FB (56.55%). Patients were admitted an average of 40.42 hours post-ingestion and referred for endoscopy within 9.28 hours. Flexible endoscopy was performed in 44.83% of cases, with a 98.46% success rate and an average procedure time of 32.25 minutes. Spontaneous passage occurred in 50.34% of cases. Poor outcomes were linked to age <1 year (OR: 7.49, p = 0.0291), delayed extraction (>48 hours; OR: 15.43, p = 0.0181), and prolonged procedures (>30 minutes; OR: 12, p = 0.0318). Good outcomes were associated with unremarkable physical exams (OR: 0.078; p = 0.0018), early admission (<=24 hours; OR: 0.1208, p = 0.0140), and timely endoscopic referral (<=24 hours; OR: 0.0314, p = 0.0187).

Conclusion. Flexible endoscopy is effective and safe for FB extraction in children. Early admission and timely intervention significantly improve outcomes, while delays and prolonged procedures increase the risk of complications.