Clinical characteristics and endoscopic outcomes of upper GI foreign bodies in children: sedated versus unsedated approaches

Abstract Objective To investigate the clinical characteristics of upper gastrointestinal foreign bodies in children and compare the clinical efficacy and safety of painless gastroscopy versus conventional gastroscopy for foreign body extraction. Methods A retrospective analysis was conducted on 278 pediatric cases (from January 2014 to June 2024) with upper gastrointestinal foreign bodies, focusing on age distribution, common types and locations of foreign bodies. Patients were divided into a painless gastroscopy group ( n = 223) and a conventional gastroscopy group ( n = 53) based on whether anesthesia was administered. In the painless gastroscopy group, intravenous access was established followed by administration of combined anesthesia (sufentanil and propofol), with the procedure initiated upon confirmation of eyelash reflex loss and muscle relaxation, while the conventional group underwent standard endoscopic foreign body extraction without sedation. The two groups were subsequently compared regarding foreign body characteristics, procedural success rates, and postoperative complication incidence. Results The age of affected children ranged from 1 month to 14 years, with a mean age of 3.285 ± 2.47 years, predominantly under 6 years old. The most common foreign body was coins, and the most frequent locations were the stomach and duodenum. The success rate of foreign body extraction was higher in the painless gastroscopy group than in the conventional group (χ 2 = 4.537, P = 0.033). Additionally, the incidence of complications in the painless group was significantly lower than in the conventional group, with a statistically significant difference (χ 2 = 10.443, P < 0.001). Conclusion Upper gastrointestinal foreign bodies in children occur most frequently in infants and young children, with coins and fragments of snacks or toys being the most common objects, primarily lodged in the stomach and duodenum. Painless gastroscopy for foreign body extraction improves treatment compliance, reduces adverse reactions, and demonstrates superior safety and efficacy compared to conventional gastroscopy, making it worthy of clinical application.