Foreign Body Ingestion In Children

GENERAL INFORMATION:

What is foreign body ingestion? 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. The esophagus is the tube that connects the mouth to the stomach. Swallowed objects usually pass through the entire digestive tract and out of the anus (rear end) without problems.

What causes foreign body ingestion? Foreign body ingestion may happen by accident or be done on purpose. Very young children may put anything in their mouth, and swallow the object. Objects may be blunt, sharp, pointed, or poisonous. These may include safety pins, small batteries, needles, school supplies, tacks, seeds, toothpicks, or pieces of toys, glass, or wood. Your child may swallow a fish bone or an animal bone while eating. Coins are the most commonly swallowed objects in children.

What are the signs and symptoms of foreign body ingestion? Your child may have pain in the neck, throat, chest, or abdomen (belly). He may refuse to eat and have trouble swallowing, gagging, or vomiting (throwing up). He may drool or there may be blood in his saliva. Your child may also have breathing problems, such as coughing or wheezing (high-pitched sound when breathing).

How is foreign body ingestion diagnosed?

• 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.
  
  
• Computerized tomography scan: This test is also called a 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 will look for the foreign body. Caregivers may also find problems with how your child's digestive tract is working.
  
  
• Metal detectors: This may be used to look for metal objects in your child's body, such as coins.
  
  
• 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 help caregivers look for the foreign body or signs of other problems. Your child may need to have more than one x-ray.

How is foreign body ingestion treated? Treatment will depend on the type and size of foreign body that your child has swallowed. Treatment also depends on how long and how far the foreign body is in the gastrointestinal (GI) tract. Most of the time, watchful waiting may be advised by your child's caregiver. Once the object is in his stomach, passing it out through the anus may be more likely. Passing out the object may take many days or weeks. Your child may also have any of the following:

• Medicines: Your child may be given sedatives and pain medicines to help him stay comfortable, calm, and relaxed. Antibiotic medicine may also be given to help treat or prevent an infection caused by germs called bacteria.
  
  
• Procedures: Removal of the object may be needed if the object is stuck in the esophagus. This is also done if the object is sharp or pointed and may cause serious problems. Removing the object 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.

Where can I find more information? Contact the following for more information:

• American Academy of Family Physicians
  PO Box 11210
  Shawnee Mission, KS 66207-1210
  Phone: 1-913-906-6000
  Web Address: http://www.aafp.org
  

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village, IL 60007-1098
  Phone: 1-847-434-4000
  Web Address: http://www.aap.org
  

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

Link to this page

Printable Version

Email Page