Foreign Body Ingestion In Children

What is foreign body ingestion in children?

Foreign body ingestion is when an object becomes stuck in your child's esophagus (throat). Coins, button batteries, small toys, and screws are commonly swallowed objects. A piece of food or a fish bone can also become stuck in your child's esophagus.

What increases the risk for foreign body ingestion in children?

The risk is highest among children ages 6 months to 3 years. This is because babies and toddlers put objects in their mouths to learn about them. Foreign body ingestion is more common among children who are mentally or physically disabled. Your child's risk increases if he has a gastrointestinal abnormality or has had gastrointestinal surgery.

What are the signs and symptoms of foreign body ingestion in children?

Your child may not have symptoms, or he may have any of the following:

  • Refusal to eat

  • Drooling or vomiting

  • Choking or gagging

  • Coughing or noisy breathing

  • Pain in his neck or throat

  • Sore throat and a runny or stuffy nose

  • Irritability and changes in behavior

  • Fever

  • Bloody vomit or rectal bleeding

How is foreign body ingestion in children diagnosed?

Your child's caregiver will examine your child's throat, chest, and abdomen. Tell him your child's symptoms. If you saw your child swallow the object, tell your child's caregiver exactly what happened and when. He may use any of the following to find the foreign body:

  • Barium swallow and other x-rays: Your child will drink thick liquid called barium while caregivers take x-rays. Barium helps his esophagus and stomach show up on x-rays. He may also need x-rays of his neck, chest, and abdomen.

  • Laryngoscopy: Your child's caregiver will use a light and a mirror to see the back of your child's throat. He may insert a tube called a scope to see deep into your child's throat.

  • Metal detector: This may be used to look for coins or other metal objects in your child's body.

  • CT scan: Your child's caregiver will use a computer to take pictures of your child's esophagus and stomach. He may be given dye by mouth or in an IV before the pictures are taken. The dye helps 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 your child's caregiver if your child is allergic to shellfish or has other allergies or medical conditions.

  • Endoscopy: Your child's caregiver will use a scope to see the inside of your child's digestive system. A scope is a long, bendable tube with a light on the end of it. A camera attached to the scope will take pictures.

How is foreign body ingestion in children treated?

Treatment depends on the object ingested, its size, and when it was ingested. Your child's caregiver may choose to observe your child for 24 hours or longer. Most foreign bodies pass through the digestive system on their own within 7 to 10 days. Objects that are small or smooth will often pass without a problem. You will need to search for the object every time your child has a bowel movement. Your child may need x-rays from time to time as you wait for the object to come out. If your child is in pain or the object is large or sharp, your child's caregiver may remove it. Your child's caregiver will look for the object in your child's throat. Your child's caregiver will remove the object if he can see it. He may need to use instruments if it is stuck so far down that he cannot see it. He may do this with any of the following:

  • Endoscopy: Your child's caregiver may use a variety of tools to remove the foreign object.

  • Forceps: This tool may be used to grab a foreign body if your child's caregiver can see it in the back of your child's throat. Forceps also may be used to remove a foreign body during endoscopy.

  • Bougienage: Your child's caregiver inserts a thin tube into your child's esophagus to widen it. He uses a tool to push the foreign body into your child's stomach. This may be done if the object is smooth and likely to pass through his digestive system normally.

  • Balloon catheter: This is a thin tube with a deflated balloon at the end. Your child's caregiver will insert the balloon catheter into your child's mouth or nose until it goes past the object. Then, the balloon is inflated. Your child's caregiver will gently pull the balloon and the object out of your child's esophagus. This may be done if the object is smooth.

  • Surgery: Rarely, your child may need surgery if other treatments fail to remove the object.

What are the risks of foreign body ingestion?

The removal of a foreign body can cause cuts and bleeding. There is a risk that the foreign body could poke a hole in your child's esophagus. Without treatment, your child is at risk for infection. Batteries can leak and injure the tissue in your child's esophagus or stomach. Large or sharp objects can cause heavy internal bleeding. This can be life-threatening.

How can foreign body ingestion in children be prevented?

  • Never leave any small item anywhere your child can reach it. Small items include coins, earrings, small toys, batteries, and magnets.

  • Teach older children to keep small toys away from babies and toddlers. Marbles are especially easy for babies to swallow.

  • Keep nails and screws away from young children. Count them before and after you finish a project.

  • Keep medicines in childproof containers.

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • The foreign object has not come out after 2 to 3 days

  • You have questions or concerns about your child's condition or care.

When should I seek immediate help for my child?

Seek immediate help or call 911 if:

  • Your child has a fever.

  • Your child's vomit is bloody.

  • Your child's bowel movement is black or bloody.

  • Your child has chest or abdominal pain.

  • Your child is choking.

  • Your child has trouble swallowing or breathing.

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. 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.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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