Foreign body ingestion in children: case series, review of the literature and guidelines on minimising accidental ingestions.

Foreign body ingestion in young children is one of the commonest presentations in the Accident and Emergency Department. It has been estimated that 40% of such ingestions may go unnoticed and the child may remain asymptomatic. However, complications can arise which may need urgent medical attention. Unwitnessed cases can delay the diagnosis as foreign bodies may remain in the oesophagus or stomach for a significant period of time causing non-specific symptoms. An index of suspicion is needed amongst primary and secondary health care practitioners to manage these cases early. Prevention of ingestion in the first place is the key to avoiding such accidents in children. Health visitors and the primary health team can play a significant role in advising parents or carers on how to make the home a safe environment for their child. Adult supervision is of the utmost importance in preschool children while playing with toys and other household objects. We present four cases of accidental ingestion of a foreign body, two of which were reportedly unwitnessed by the carers. Each case carries a lesson for prevention. We discuss clinical aspects of foreign body ingestion in children and provide some guidelines to minimise the risk of accidental ingestions that primary health care professionals can discuss with parents and carers during home visits. Health educational resources for parents and clinics are suggested.