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Foreign Body Ingestion

more about Foreign Body Ingestion


Foreign object ingestion



  • Swallowing objects that are not food.
  • Coins are frequently-swallowed objects.

  • Usually no symptoms, but occasionally swallowing difficulty, pain in the esophagus, abdominal pain, or bleeding, especially if the object is sharp or large.
  • The most common objects that become lodged in the throat or esophagus are fish bones.  If a swallowed object is going to become lodged and require extraction, it is most likely to happen in the upper esophagus.  Foreign bodies lodged in the back of the throat or esophagus are likely to produce pain in the local area, gagging or difficulty swallowing, and salivation (drooling) or vomiting; sometimes coughing.
  • Occasionally, large objects such as closed safety pins pass into the stomach and then are too large to pass through the pylorus (the exit from the stomach into the intestine).  It is generally true that if an object passes through the pylorus, it can go through the rest of the bowel and pass into the stool.
  • Another location that traps objects and prevents their passage into the stool is the ileocecal valve between the small intestine and large intestine.
  • Objects trapped in the stomach or intestines often produce vomiting, a distended abdomen, and possibly bleeding.

  • It is natural that children will swallow these objects, since children commonly place objects in the mouth in the early years of life, or hold objects in the mouth for convenience (paper clips, erasers, coins).

  • History that the baby or child had an object in the mouth, and then seemed to swallow it.  Unless the object becomes lodged in the throat, or produces coughing and gagging, there are usually no symptoms initially.  If the swallowed object is sharp, such as a straight pin, it may produce pain or bleeding.
  • Usually no abnormalities on physical examination
  • Plain X-ray (without contrast material) usually reveals objects such as coins or metal pins.  For objects that do not show up on X-ray, special techniques might be needed, such as adding contrast material.
  • Objects likely to have a hard time passing through the loops and turns in the intestine are long, sharp objects such as needles.
  • Objects that become trapped may produce torn tissue, bleeding, and perhaps a bowel obstruction.

  • Children below the age of 6 years
  • Previous abnormalities in the esophagus, stomach, or intestinal tract make a child more likely to have a swallowed foreign body obstruct or perforate at the site of the abnormal anatomy.

  • The parent should not try to make the affected child vomit, since the object might then become stuck in a more dangerous location.
  • If the foreign body produces symptoms right away (which usually means an object is stuck in the esophagus), urgent treatment at the hospital is likely needed.  This treatment is usually sedation of the child, and then extraction of the object, using an endoscope (a flexible tube with a light source, suction, and a grasping instrument).  Some physicians are skilled at using other means to dislodge an object stuck in the esophagus, such as threading a catheter up to the point of blockage.
  • If the object does not need to be removed immediately, commonly, the progress of the object is followed by having the parent examine the stool closely until the object is passed, and report any symptoms.  In the case of a very small object which is likely to pass into the stool without difficulty, physicians might not re-X-ray unless it takes more time than expected, (2-3 days) for the object to pass into the stool.  More dangerous objects, like open safety pins, might be followed with repeat X-rays and repeat examinations.
  • Objects that become lodged further down than the endoscope can reach might need to be extracted by intestinal surgery.
  • Objects that might contain toxic chemicals, such as batteries, might need to be extracted even though the object's shape might not cause obstruction.

  • An object may create an ulcer, or erosion through the wall of the esophagus, stomach, or intestine.
  • Bowel obstruction
  • Infection
  • Complications such as perforation or bleeding can occur during attempts to remove the object.

  • Recognize that if a child swallows a foreign body, this might become an emergency.  Call for medical advice immediately or dial 911.
  • Children suspected of having swallowed a foreign body should not be given food or drink until permitted to do so by their physician.  Food or drink in the stomach would likely be dangerous if the child needs a trip to the operating room.

  • Mouthed foreign bodies that become lodged in the trachea (windpipe) may also press on the esophagus, which is right next to the trachea.  The child is likely to have coughing, hoarseness, and shortness of breath from an object in the trachea or voice box area, but also might have swallowing difficulty from pressure on the esophagus.




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