Foreign bodies injuries in children: analysis of Thailand data

OBJECTIVES: Suffocation due to foreign bodies (FB) is a leading cause of death in children aged 0-3 and it is common also in older ages, up to 14 years old. Based on the RPA report the estimated number of incidents per year in children aged 0-14 is in European Union (EU) of approximately 50,000, 10% of which are fatal. The need of an improvement of knowledge led to the development of the pan European study ESFBI (European Survey on Foreign Bodies Injuries) that collected data on FB injuries in the aerodigestive tract in paediatric patients from 19 European Hospitals (Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Finland, Germany, Greece, Italy, Poland, Romania, Slovakia, Slovenia, Spain, Sweden, Swiss, Turkey and United Kingdom). Recognizing that the rapid management is one of the main goals in the presence of such injury the aim of this paper is to confront data coming from 4 ESFBI case series with a Thailand's case series, in order to broaden the knowledge on FBs injuries characteristics, knowing that features like shape, dimension, consistency are fundamental in determine the consequences that might occur.

METHODS: Data coming from the Siriraj Hospital, Thailand from June 2006 to 2010 were collected and compared with 4 case series chosen amongst the ESFBI study cases (Finland, Slovenia, Sweden and Turkey).

RESULTS: 172 cases were collected from the Siriraj Hospital in Bangkok, Thailand. The chosen ESFBI members were Finland, Sweden, Slovenia and Turkey, with a sample numerosity respectively of 307, 235, 104 and 196 cases. All countries showed a male prevalence higher than the female one, and injuries occurred most frequently in children younger than 3 years old. The most frequent retrieval location was the digestive system (oesophagus) in Thailand data (97 cases, 56.40% of cases), whilst European cases involved more frequently the nose in Slovenia (58.65%), Finland (37.79% of cases) and Sweden (54.47%). In Turkey's case series, the highest prevalence of cases interested the airways. In Thailand and Finland case series, the main FB's type were represented by bones (respectively 66 case, 38.37% and 48 cases, 15.64%), whilst pearl, ball and marble were the most frequent FB both in Slovenia (16, 15.38%) and Sweden (83, 35.32%). Turkey case series had nuts, seeds and grain as most prevalent FB (126, 64.29%).

CONCLUSIONS: The nature of foreign bodies varies from country to country and is dependent on diverse cultural, social, religious and economic factors that include parental attitudes, eating habits, availability and types of potentially threatening objects, and prevention strategies. The need to study in more depth specific characteristics of foreign bodies associated with increased hazard, such as nature, size, shape, hardness or firmness, lubricity, pliability and elasticity, in order to better identify risky foods and to describe more precisely the pathogenetic pathway is therefore a necessity.