Foreign body ingestion

Children aged <1 year and adults aged >75 years have an increased risk of dying following foreign body ingestion. Fatalities and other major complications are linked to the type of foreign body, location, and duration of the impaction. Therefore, early recognition and removal allow the best chances of recovery with minimal complications.

Most ingested/inserted foreign bodies will pass through the alimentary tract asymptomatically (80% of the cases) causing only minor mucosal injury.

Large spherical or cylindrical objects may or may not pass through the oesophagus. Once a foreign body has reached the stomach, it has a >90% chance of passage without difficulty. Therefore, periodic x-rays to ensure that they have moved through and out of the body are recommended.

Objects >6 cm long may become entrapped by either the pylorus or the duodenal sweep, and objects >2.5 cm in diameter may also fail to pass the pylorus. These objects should be removed endoscopically within 24 hours.

The corrosive nature of an alkaline battery can lead to gastrointestinal (GI) tract erosion or complications.

The length of observation following removal of the retained object is variable. It depends partly on the clinical status of the patient, the physical characteristics of the object removed, any resultant trauma associated with it, and the method used for removal (spontaneous, endoscopic, or surgical).

Continuation of perioperative antibiotics is not necessary following simple extraction without complications.

In most cases of upper or lower foreign body obstruction, GI follow-up is recommended. These patients should have a second endoscopic examination with either upper endoscopy or flexible sigmoidoscopy to evaluate for underlying pathology that may explain the obstruction.