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ESOPHAGEAL FOREIGN BODY IN CHILDREN

Esophageal Foreign Body in Children

WHAT YOU NEED TO KNOW:

What is esophageal foreign body in children? Esophageal foreign body is an object your child swallowed that got stuck in his 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 my child's risk for esophageal foreign body? 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. Esophageal foreign body 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 esophageal foreign body in children?

  • 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 esophageal foreign body in children diagnosed? Your child's healthcare provider 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 healthcare provider exactly what happened and when. He may use any of the following to find the object:

  • A barium swallow or other x-rays may be used to check your child's neck, chest, and abdomen. He will drink thick liquid called barium while healthcare providers take x-rays. Barium helps your child's esophagus and stomach show up on x-rays.

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

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

  • A CT may be used to check for objects in your child's esophagus or stomach. He may be given contrast liquid to help his esophagus and stomach show up better. Tell the healthcare provider if your child's has have ever had an allergic reaction to contrast liquid.

  • Endoscopy may be used 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 esophageal foreign body in children treated? Treatment depends on the object, its size, and when it was swallowed. Your child's healthcare provider may choose to observe your child for 24 hours or longer. Most objects pass through the digestive system on their own within 7 to 10 days. 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 healthcare provider may remove it. He will look for the object in your child's throat and 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 may be used to remove the object.

  • Forceps may be used to grab the object if your child's healthcare provider can see it in the back of your child's throat. Forceps also may be used to remove the object during endoscopy.

  • Bougienage is a procedure used to push the object into your child's stomach. Your child's healthcare provider will insert a thin tube into your child's esophagus to widen it. This may be done if the object is smooth and likely to pass through your child's digestive system normally.

  • A balloon catheter may be used to pull the object out of your child's esophagus. The catheter is a thin tube with a deflated balloon at the end. Your child's healthcare provider will insert the balloon catheter into your child's mouth or nose until it goes past the object. He will then inflate the balloon. This procedure may be done if the object is smooth or blunt.

  • Surgery may be needed if other treatments fail to remove the object.

How can esophageal foreign body 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.

Call 911 for any of the following:

  • Your child has chest or abdominal pain.

  • Your child is choking.

When should I seek immediate care?

  • Your child has a fever.

  • Your child's vomit is bloody.

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

  • Your child has trouble swallowing or breathing.

When should I contact my child's healthcare provider?

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

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

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.