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Foreign object - swallowed

Definition

If you swallow a foreign object, it can get stuck along the gastrointestinal (GI) tract from the esophagus (swallowing tube) to the colon (large intestine). This can lead to a blockage or tear in the GI tract.

Alternative Names

Foreign body ingestion

Considerations

Children ages 6 months to 3 years are the age group most likely to swallow a foreign object.

These items may include coins, marbles, pins, pencil erasers, buttons, beads, or other small items or foods.

Adults can also swallow foreign objects due to intoxication, mental illness, or dementia. Older adults who have swallowing problems may accidentally swallow their dentures. Construction workers often swallow nails or screws, and tailors and dressmakers often swallow pins or buttons.

Causes

Young children like to explore things with their mouths and may swallow an object on purpose or by accident. If the object passes through the food pipe and into the stomach without getting stuck, it will probably pass through the entire GI tract. Sharp, pointed, or caustic objects such as batteries can cause serious problems.

Objects will often pass through the GI tract within a week. In most cases, the object passes through without harming the person.

Symptoms

Symptoms include:

  • Choking
  • Coughing
  • Wheezing
  • Noisy breathing
  • No breathing or breathing trouble (respiratory distress)
  • Chest, throat, or neck pain
  • Turning blue, red, or white in the face
  • Difficulty swallowing saliva

Sometimes, only minor symptoms are seen at first. The object may be forgotten until symptoms such as inflammation or infection develop.

First Aid

Any child who is believed to have swallowed a foreign object should be watched for:

  • Pain (mouth, throat, chest, or abdominal)
  • Fever
  • Drooling
  • Abnormal breathing
  • Vomiting
  • Local tenderness

Stools (bowel movements) should be checked to see if the object has passed through the body. This will take several days and may sometimes cause rectal or anal bleeding.

A procedure called endoscopy may be needed to confirm if the child has swallowed an object and to remove it. Endoscopy will be done if the object is long or sharp, or is a magnet or disk battery. It will also be done if the child has drooling, breathing difficulty, fever, vomiting, or pain. X-rays may also be done.

In severe cases, surgery may be needed to remove the object.

Do Not

DO NOT force feed infants who are crying or breathing rapidly. This may cause the baby to inhale liquid or solid food into their airway.

When to Contact a Medical Professional

Call a health care provider or local emergency number (such as 911) if you think a child has swallowed a foreign object.

Prevention

Preventive measures include:

  • Cut food into small pieces for young children. Teach them how to chew well.
  • Discourage talking, laughing, or playing while food is in the mouth.
  • Do not give potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, food with bones, or hard candy to children under age 3.
  • Keep small objects out of the reach of young children.
  • Teach children to avoid placing foreign objects into their noses and other body openings.

References

Khan S, Orenstein SR. Foreign bodies in the esophagus. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 327.

Pfau PR, Hancock SM. Foreign bodies, bezoars, and caustic ingestions. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 27.

Schoem SR, Rosbe KW, Bearelly S. Aerodigestive foreign bodies and caustic ingestions. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 207.

Thomas SH, Goodloe JM. Foreign bodies. In Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 53.


Review Date: 4/4/2018
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Emeritus, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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