Israeli Doctor Leads International Effort on Foreign Object Ingestion in Children
Translated & summarized from Israel Hayom by baba
An Israeli doctor, Dr. Oren Leder, initiated a new international guideline for treating children who ingest foreign objects, published by ESPGHAN. The paper addresses risks from batteries, magnets, and sharp objects, offering guidance on when immediate intervention is needed. Battery ingestion poses a high risk of rapid damage, while magnet ingestion has surged globally. The guideline aims to standardize care for these common pediatric emergencies.
The story in 6 lines · by baba
- Dr. Oren Leder of Shaare Zedek Medical Center led the creation of a new international guideline on foreign object ingestion in children.
- The ESPGHAN position paper provides guidance on urgent interventions versus observation for ingested objects.
- Button battery ingestion is particularly dangerous, with potential for severe damage within minutes and increased complications after 12 hours.
- Honey is recommended for children over one year old who swallow batteries to mitigate chemical damage before emergency care.
- There has been a significant global increase in magnet ingestion cases, posing risks of perforation and necrosis.
- Sharp objects and multiple magnets require immediate medical attention due to perforation risks.
A new position paper from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), initiated by an Israeli doctor, provides a global guideline for managing cases of foreign object ingestion in children and adolescents. The paper, published in a leading journal, aims to set a worldwide standard for pediatric gastroenterologists and emergency room physicians.
Dr. Oren Leder, Director of the Pediatric Endoscopy Unit at Shaare Zedek Medical Center and head of research in the endoscopy department at ESPGHAN, spearheaded the initiative alongside 18 experts from approximately 10 countries. The guideline details when urgent intervention is necessary, the risks associated with different types of ingested objects, and when observation is sufficient until the object is naturally expelled.
The paper highlights the dangers of button battery ingestion, noting a fivefold increase in complication risk after 12 hours due to potential electrical reactions. Initial esophageal damage can occur within 15 minutes. For children over one year old who have swallowed a battery, parents are advised to give two teaspoons of honey every ten minutes up to six times and seek immediate emergency room care, as honey may insulate the battery and prevent chemical damage.
Ingestion of magnets has seen a significant rise, with a 450% increase in the U.S. since 2018. Swallowing multiple magnets can lead to serious complications, including adherence through different intestinal walls, tissue pressure, perforation, and necrosis, necessitating immediate endoscopic removal if accessible.
Sharp objects like needles, nails, or fish bones also pose a perforation risk. The decision for intervention depends on the object's location and the balance between the risk of leaving it and the risk of removal. In asymptomatic cases where the object has moved beyond the esophagus, continuous clinical and imaging monitoring may be considered. Surgical intervention is an option if endoscopic removal is unsafe or significant complications like bowel obstruction or necrosis are suspected.