CLINICAL SPECTRUM OF ENT FOREIGN BODY PRESENTATION AMONGST PEDIATRIC POPULATION; IN EMERGENCY DEPARTMENT OF LOW RESOURCE TERTIARY CARE HOSPITAL KARACHI.

Abstract

Background: Pediatric ear  nose  and throat (ENT) and aerodigestive foreign bodies (FBs) represent   frequent emergency presentation. In low-resource settings  delayed presentation and limited subspecialty resources exacerbate potential morbidity.

Objective: To determine   clinical spectrum  anatomical distribution  triage characteristics  and disposition outcomes of pediatric ENT and aerodigestive FB presentations in   low-resource tertiary emergency department (ED).

Methods:   cross-sectional study of 397 pediatric patients ( < 14  years) presenting with ENT or aerodigestive FBs to Indus Hospital and Health Network  Karachi  was conducted from February to May  2025. Demographic  anatomical  object category  triage  and ED disposition data were analyzed using SPSS v20. Categorical relationships and disposition odds were evaluated using Chi-square tests  Fisher’s exact tests  and Mantel–Haenszel stratified analyses ( p < 0.05 ).

Results:   mean age was  4.32 SD 2.84  years  with 69.5% under 5 years and   slight male predominance (51.9%). Nasal FBs were most common (38.8%)  followed by ingested/alimentary (33.0%) and aural FBs (22.4%). Age group was significantly associated with anatomical site ( p < 0.001 )  with nasal FBs dominating in toddlers (2 – <5 years: 53.2%) and ingested FBs dominating in infants (<2 years: 63.0%). Most cases were triaged as P2 (41.1%) or P3 (54.2%). Direct discharge was achieved in 74.8% of cases  while 25.2% required non-discharge pathways (referral  admission  absconded  or LAMA). Aerodigestive FBs yielded significantly higher odds of non-discharge than localized nasal/aural FBs (p < 0.001). Stratified analysis confirmed age as   significant effect modifier ( p = 0.042 )  with toddlers (2–<5 years) facing   4.31-fold non-discharge risk ( p < 0.001

Conclusion: Pediatric ENT FB presentation is developmental stage-dependent. Aerodigestive FBs—particularly in children aged 2–<5 years—significantly increase non-discharge outcomes  demanding structured ED triage pathways and specialized pediatric care in low-resource environments.