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Foreign Bodies in a Pediatric Emergency Department in South Africa

Timmers, Maarten MSc*; Snoek, Kitty G. MSc*; Gregori, Dario MD, PhD; Felix, Janine F. MD, PhD; van Dijk, Monique PhD*; van As, Sebastian A.B. MBA, FCS(SA), PhD(UCT)§

doi: 10.1097/PEC.0b013e318276c20e
Original Articles

Objectives Foreign body–related pediatric trauma has a high incidence, but studies with large data sets are rare and typically stem from Western settings. The aim of this study was to identify characteristics of foreign body–related trauma in children treated at our trauma unit in South Africa.

Methods In this retrospective study, we analyzed all foreign body–related trauma admissions from 1991 to 2009. We collected detailed data including age, sex, type of foreign body, injury severity, and anatomical location of the foreign body.

Results We analysed 8149 cases. Marginally more boys (54.9%) than girls were involved. The overall median age was 3 years (interquartile range, 2-6 years); 78.8% were younger than 7 years. The predominant anatomical sites were the respiratory tract and the gastrointestinal tract (39.1%); ears (23.9%); nose (19.4%); and extremities (8.8%). The commonest objects were coins (20.8 %), (parts of) jewelry (9.5%), and food (8.7%). Three quarters (74.5%) of patients presented between 1 and 2 hours after the injury (median, 1 hour). A total of 164 cases (2.0%) were marked as possible child abuse; 17 cases were filed as confirmed child abuse.

Conclusions Preventive parent education programs targeting foreign body–related injury should mainly focus on both sexes younger than 7 years. Parents should be taught to keep small objects out of reach of young children, especially coins, because these most often result in a trauma unit visit.

From the *Sophia Children’s Hospital, Department of Pediatric Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands; †Laboratories of Epidemiological Methods and Biostatistics, Department of Environmental Medicine and Public Health, University of Padova, Padua, Italy; ‡Division of Clinical Epidemiology and Aging Research, German Cancer Research Centre, Heidelberg, Germany; and §Department of Pediatric Surgery, Red Cross War Memorial Children’s Hospital, Cape Town, South Africa.

Disclosure: The authors declare no conflict of interest.

Reprints: M. van Dijk, room SK 1276 Erasmus MC-Sophia Children’s Hospital, Department of Pediatric Surgery PO BOX 2060 3000 CB Rotterdam, the Netherlands (e-mail:

M. Timmers and K.G. Snoek contributed equally to this article.

© 2012 Lippincott Williams & Wilkins, Inc.