Surgical intervention is rarely required (in 1-2% of cases). Absolute indication Perforation (breakthrough) Relative indications Endoscopic (“by mirroring”) not controllable complications. Unsuccessful endoscopic salvage attempts. Lingering of a foreign body in the distal duodenum (duodenum) for longer than one week
Prevention factors Store batteries, button cells inaccessibly In general, small parts where there is a risk of ingestion should not be stored within reach of children. Toys should be age appropriate. Information from the manufacturer can be found on the toys. Offer foods with age in mind. Unsuitable for toddlers are nuts, seeds, popcorn, large … Foreign Body Ingestion: Prevention
Symptomatology depends on the size, shape, and material of the foreign body. In some cases, foreign body ingestion initially remains asymptomatic. The following symptoms and complaints may indicate foreign body ingestion: Main symptoms Gagging, recurrent (recurring) vomiting of undigested food. Dysphagia (difficulty swallowing). Foreign body sensation Strong salivation (salivation), possibly persistent Refusal of food Retrosternal … Foreign Body Ingestion: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Foreign body ingestion primarily affects young children. They put objects in their mouths out of curiosity or accidentally during play and swallow them unintentionally. Etiology (causes) Biographic causes Advanced age Disease-related causes (especially in adults). For a foreign body impaction Mental retardation Malignancies (about 10%) Motility disorders of the esophagus. Achalasia … Foreign Body Ingestion: Causes
The history often presents as difficult or not as informative as desirable because the event was rarely observed or noticed. The anamnesis (medical history) represents an important component in the diagnosis of foreign body ingestion. If the child is not yet able to speak or is unable to speak meaningfully, the history is taken through … Foreign Body Ingestion: Medical History
Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Hemorrhoids Invagination (invagination of a portion of the intestine into the aborally following portion of the intestine). Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Abdominal pain (abdominal pain) Dysphagia (difficulty swallowing) Hematemesis (vomiting blood; coffee grounds vomiting). Melena (blood in the stool)
The following are the most important diseases or complications that may be contributed to by foreign body ingestion: Respiratory system (J00-J99) Mediastinitis (inflammation of the connective tissue of the mediastinal cavity) due to perforation (rupture). Obstruction of the airways Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Bleeding Pressure necrosis (necrosis = tissue death) … Foreign Body Ingestion: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore: Inspection (viewing). Skin, mucous membranes Oral cavity [due tosymptom: severe salivation (salivation), persistent under certain circumstances]. Larynx (larynx) Pharynx (throat) Abdomen (abdomen) Note: If the event was not … Foreign Body Ingestion: Examination
Therapeutic targets Foreign body extraction (removal of the foreign body). Avoidance of complications Therapy recommendations Prokinetics (medications that stimulate natural bowel movement) should not be administered for sharp or pointed foreign bodies. For foreign bodies, especially impaction of a food bolus (swallowable morsel), that are stuck in the lower esophagus and not at risk of … Foreign Body Ingestion: Drug Therapy
Diagnostic imaging should be performed as close to the planned intervention as possible because the location of the injected foreign body may change. Mandatory medical device diagnostics. Radiograph of the thorax (X-ray thorax/chest) – lateral if necessary – and abdomen (abdominal cavity) (“from mouth to anus”), in two planes – an ingested foreign body is … Foreign Body Ingestion: Diagnostic Tests
