Ingestion of foreign bodies and caustic substances in children: a narrative review on clinical evaluation and management update

The ingestion of foreign bodies and caustic substances represents a significant clinical concern in pediatric populations, particularly among children aged 1-5 years. These events can result in a wide spectrum of complications ranging from acute, life-threatening emergencies to delayed sequelae with long-term morbidities. The severity and clinical course are influenced by multiple factors, including ingested material's nature, size, shape, and chemical composition, as well as its anatomical location, particularly when esophageal impaction occurs. High-risk foreign bodies- such as button batteries, high-powered magnets, sharp objects, superabsorbent polymers, and items containing toxic substances-pose an elevated risk of rapid tissue injury or perforation. Similarly, the ingestion of caustic agents, whether acidic or alkaline, carries the potential for extensive mucosal damage, with the degree of injury dictated by the pH, volume ingested, and inherent toxicity. Clinical management requires a highly individualized, case-by-case approach guided by the clinical presentation, imaging findings, and endoscopic evaluation findings. Endoscopy plays a pivotal role in the diagnostic assessment of mucosal injury and is a therapeutic modality for foreign body retrieval. Timely endoscopic interventions are strongly associated with improved outcomes and reduced complication rates. A high index of clinical suspicion remains critical to ensuring early diagnosis, prompt intervention, and the prevention of both acute and long-term complications, including strictures, perforations, and impaired quality of life. Comprehensive, multidisciplinary management is essential for optimizing patient outcomes in these potentially complex clinical scenarios.