Foreign Body Ingestion In Children

WHAT YOU SHOULD KNOW:

  • Foreign body ingestion is the swallowing of an object other than food. This commonly happens in children aged six months to six years who tend to put things into their mouths. Once an object is swallowed, it may get stuck in the esophagus or get trapped in the stomach. Swallowed objects usually pass through the entire digestive tract and out of the anus (rear end) without problems. Foreign bodies may include coins, small batteries, pins, seeds, toothpicks, pieces of toys, or fish or animal bone.
    Picture of the digestive system of a child


  • Pain in the neck, throat, chest, or abdomen (belly) may be symptoms of foreign body ingestion. Your child may refuse to eat or have trouble swallowing, gagging, vomiting (throwing up). He may also have breathing problems, such as coughing or wheezing (high-pitched sound when breathing). Tests, such as barium swallow, computerized tomography (CT) scan, endoscopy, or x-rays may be needed for diagnosis. Treatment will depend on the object's type and size and how long it has been inside the body. Your child may need to have a procedure or surgery done to remove the foreign body. Your child's caregiver may suggest waiting until the object is passed out in your child's bowel movement. With treatment and care the foreign body will come out and more serious problems can be prevented.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Removal of an ingested foreign body may cause unpleasant effects. The esophagus may be scraped, scratched, or injured. The object accidently may go into your child's airway and this may be life-threatening. Surgery has a risk of bleeding and infection. A foreign body left in the body for a long time may make your child's symptoms worse. If the foreign body is not removed, it may cause an infection, irritation, swelling, or bleeding. It may block the bowel or cause tears with leakage of the bowel's contents inside the abdomen. The foreign body itself may contain chemicals which may be poisonous. Ask your child's caregiver if you have questions about his condition and its treatment.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Medicines:

Caregivers may give your child the any of the following:

  • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.

  • Glucagon: This medicine helps relax the muscles in the lower part of the esophagus. The esophagus is the tube that carries food from the mouth to the stomach. Relaxing your esophagus is helpful if there is an object stuck in it.

  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

  • Sedative: This medicine may be given to help your child to be calm and relaxed.

Tests:

Your child may have any of the following:

  • Barium swallow: A barium swallow is an x-ray of your child's throat and esophagus. This test may also be called a barium esophagram. Your child will be given thick liquid called barium. Barium helps your child's esophagus and stomach show up better on x-rays. Follow the instructions of your child's caregiver before and after the test.

  • CT scan: A special x-ray machine uses a computer to take pictures of your child's digestive tract. Your child may be given dye by mouth or in an IV before the pictures are taken. The dye may help your child's caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if your child is allergic to shellfish, or has other allergies or medical conditions.

  • Endoscopy: Endoscopy is a test that uses a scope to see the inside of your child's digestive tract. A scope is usually made of a long, bendable tube with a light on the end of it. A camera may be hooked to the scope to take pictures. During an endoscopy, caregivers look for the foreign body. Caregivers may also find problems with how your child's digestive tract is working.

  • Fluoroscopy: Fluoroscopy is a special type of x-ray that shows movement of joints, organs, and parts of the body. Body parts are shown on a screen for the caregiver. If treatment includes inserting a catheter into your child's digestive tract, fluoroscopy may be used to check catheter placement.

  • X-rays: X-rays of different parts of your child's body may be taken. These may include the neck, chest (lungs and heart), or abdomen. X-rays may help caregivers look for the foreign body or signs of other problems. Your child may need to have more than one x-ray.

Treatment options:

Removal of the foreign body may be done using any of the following:

  • Bougienage: Caregivers will insert a thin tube into the esophagus to widen it. They will then push the object into the stomach using another instrument. Bougienage is done if the object is smooth and blunt, and likely to be passed out the body. This may also be done if the object was swallowed within the past 24 hours.

  • Endoscopy: A scope with a camera is passed through your child's mouth into his digestive tract. Caregivers look for the foreign body and remove it through the scope using different instruments. Objects may be grasped using forceps, or caught using a net. If the object to be taken out is sharp or pointed, it may be pulled out of the mouth. Caregivers may also treat other problems, such as bleeding. Endoscopy may also be used to take out an object that cannot go past the stomach.

  • Foley catheter: Caregivers insert a catheter (rubber tube) into the mouth or nose until it goes past the object. With fluoroscopy (a special type of x-ray) as a guide, the balloon at the end of the catheter is filled, and gently pulled out. This may be done if the object is smooth or blunt, such as a coin. A catheter may be used when the object was swallowed within the past 24 hours.

  • Surgery: Your child may need to have surgery if many objects were swallowed, or if the swallowed object was large. This may also be done to look for an injury or problem caused by the foreign body. Caregivers may also repair or treat the injury or problem during surgery.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Foreign Body Ingestion In Children (Inpatient Care)

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