Foreign Body Ingestion and Aspiration

Abstract

1. Marisa C. Louie, MD* 2. Stuart Bradin, DO* 1. *Pediatric Emergency Medicine Division, Department of Emergency Medicine, University of Michigan, Ann Arbor, Mich After completing this article, readers should be able to: 1. Recognize the presenting history, signs, and symptoms of patients who have swallowed or inhaled foreign bodies. 2. Discuss the long-term complications of gastrointestinal and airway foreign bodies. 3. Describe appropriate management strategies for patients who have common esophageal and gastric foreign bodies. 4. Identify the risks associated with ingestion of button batteries and recognize when emergent removal is necessary. 5. Maintain a high level of suspicion for aspirated foreign bodies, recognizing that delays in diagnosis can lead to increased complications. ### Case 1 A 3-year-old boy is brought to his pediatrician's office by his mother after an older sibling saw him swallow two small pieces from a magnetic building set. He is playful and smiling. There is no history of choking or distress. Radiography reveals two small rodlike objects in his stomach. ### Case 2 A 10-year-old girl who has developmental delay is brought to the emergency department after possibly swallowing a calculator battery 2 hours ago. She is asymptomatic. On the radiograph, a small round object is seen in the lower esophagus. ### Case 3 A 2-year-old boy is brought into an urgent care facility for new-onset wheezing. He has a low-grade fever and cough but no rhinorrhea. He has mild tachypnea with wheezing on the right side. Albuterol treatments and steroids are started. In spite of several treatments, he continues to wheeze. These three cases are examples of a common pediatric problem: foreign body ingestion and aspiration. Because toddlers explore the world with their mouths, tend to eat and run, and have a less developed chewing ability, they are the most common age group seen for foreign body complaints. Many studies report a slight male predominance. This review addresses foreign body ingestion and aspiration. ### Background Foreign body ingestion is a frequent reason for pediatric visits. Coins are common culprits, followed by small toys …