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Emergency Medicine News

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When Does a Pediatric Foreign Body Ingestion Need Emergent Care?

Fadial, Tom MD

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doi: 10.1097/01.EEM.0000547804.60735.e9
    Figure
    Figure:
    Algorithm for Evaluating and Managing Pediatric Foreign Body Aspiration
    Figure
    Figure

    A healthy 5-year-old boy was brought to the pediatric emergency department after he told his parents that he accidentally swallowed a coin. He had no complaints and appeared to be breathing comfortably. He was also tolerating secretions normally. A plain radiograph was obtained.

    Should he receive an endoscopy? The indications for emergent endoscopy include esophageal button battery, severe symptoms, a sharp foreign body in the esophagus, and multiple magnets in the esophagus or stomach.

    This patient remained well-appearing, and was discharged with primary care follow-up.

    Figure
    Figure
    Figure
    Figure:
    Esophageal foreign bodies typically orient coronally. A coin, for example, will appear as a circle on an anteroposterior projection.
    Figure
    Figure:
    Tracheal foreign bodies typically orient sagittally. A coin will appear as a line on an anteroposterior projection.

    Suggested Readings:

    • Sahn B, et al. Foreign Body Ingestion Clinical Pathway. 1 Aug. 2016; http://bit.ly/2yML4wK.
    • Wyllie R. Foreign bodies in the gastrointestinal tract. Curr Opin Pediatr 2006;18(5):563.
    • Uyemura MC, et al. Foreign body ingestion in children. Am Fam Physician 2005;72(2):287; http://bit.ly/2yqffdH.
    • Louie MC, Bradin S. Foreign body ingestion and aspiration. Pediatr Rev 2009;30(8):295.
    • Green SS. Ingested and aspirated foreign bodies. Pediatr Rev 2015;36(10):430.
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