Patterns, Management and Outcomes of Patients With Aero-digestive Tract Foreign Bodies at Kenyatta National Hospital

Abstract

Study background: Aero-digestive foreign bodies (F.B.s) are increasingly being encountered in the surgical units in many hospitals. F.B. lodgement in the aero-digestive tract constitutes an important cause of significant morbidity and mortality in patients. Whereas it is notably common, a dearth of information exists on its patterns, treatment, and associated outcomes. Broad objective: The broad objective was to establish the pattern, management, and outcomes of foreign body aspiration and ingestion at Kenyatta National Hospital. Study design: Retrospective cohort study. Study site: Kenyatta National Hospital, records department. Participants and methods: All patients who were admitted and treated for foreign body aspiration and ingestion at the KNH from January 2017 to December 2021 were recruited through consecutive sampling. Data was collected on demographic and clinical characteristics, treatment methods, and outcomes (determined by length of hospital stay, mortality, and morbidity) of F.B. aspiration and ingestion. Data analysis: The collected data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 26. Descriptive statistics such as means and medians were used in the description of the characteristics of the study participants. Chi-square tests were used in comparing categorical variables and proportions across groups. Continuous variables were compared using a student t-test. 11 A p-value of less than 0.05 was considered statistically significant. Data was presented in written reports, frequency tables, bars, and pie charts. Results: A total of 196 participants were recruited, aero-digestive F.Bs occurred more commonly in the paediatric population with a mode of 2-3 years, and a female preponderance at 53.06%. Symptoms lasted an average of 32.6 days, with an SD of 136. Endoscopy (83.67%) was the most commonly utilized method of extraction. Foreign bodies commonly lodged in the esophagus (73.47%), then bronchi (18.37%), and trachea (1.53%). Hospital stay averaged at 4.5 days with an SD of 8.1, and no mortalities were reported. Morbidity was observed in 9.18% of the patients. Conclusion: The study revealed aero-digestive foreign bodies were encountered more commonly in the pediatric population, with coins being the most frequently ingested and button batteries causing the most morbidity. A high index of suspicion for foreign body ingestion and aspiration should be maintained for children with a history of treatment for respiratory tract infection and those with overt symptoms such as drooling, dysphagia, odynophagia, and weight loss. Surgery was performed in patients who the foreign body could not be extracted via endoscopy and for longstanding foreign bodies, while watchful waiting was an option for ingestions that showed distal migration on imaging. Early diagnosis, referral, and intervention are crucial to alleviate associated morbidity