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| ==Background==
| | #Redirect [[Ingested foreign body]] |
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| *Most common site in upper 1/3 of esophagous
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| *5% of FB are more than 1 FB
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| *Disk batteries can cause esophageal burns 4hrs & perf in 6hrs
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| == ==
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| ==Diagnosis==
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| Clinical
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| Consider CXR and/or soft tissue lateral x-ray
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| (soft tissue lateral of neck, cxr, kub), if no FB on xr (radiolucent, ie plastic, button), but child w/ sx or strong hx of recent FB ingestion, then endoscopy is indicated.
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| *Coins in the esoph are in coronal plane & coins in trachea in the sagital plane
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| ==DDx==
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| Tracheal/lung aspiration
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| ==Treatment==
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| STABLE
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| 1) Food bolus (soft; ie. no bones)
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| -glucagon (caution causes vomiting)
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| -fails --> endosopic removal
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| 2) Coin (or similar round/smooth FB)
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| a. Below diaphram
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| i. asymptomatic
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| -d/c home, check stool x 1 wk, repeak KUB if not passed as outpt
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| ii. sx obstruction or perf
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| -surgery
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| b. Above diaphram
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| i. asymptomatic
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| -Obs + repeat XR x 6hrs
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| -Consider "Foley manuver" if fails Obs
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| 3) Disk or button battery
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| a. Esophagus --> immediate removal (endoscopy)
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| b. Below diaphram
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| i. asymptomatic
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| -Outpt obs with close f/u
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| -needs to be removed if still in stomach after 24-48hr
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| ii. Sypmtomatic
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| -immediate removal (endoscopy)
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| 4) Sharp (ie bone, pin, etc) or long (>3-6cm)
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| a. Esophagous, stomach, and/or symptomatic
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| --> Immediate removal (endoscopy)
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| b. Below stomach and asymptomatic
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| -->Outpt obs with close F/U
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| -perf rare (<1-2%)
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| ==See Also==
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| GI: Esophageal Foreign Body
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| ==Source==
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| 6/04 EM Reports- By Lampe
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| [[Category:Peds]] | |
