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Foreign bodies of the esophagus and gastrointestinal tract in children

Authors
Mark A Gilger, MD
Ajay K Jain, MD
Mark E McOmber, MD
Section Editors
Jonathan I Singer, MD
Melvin B Heyman, MD, MPH
Deputy Editor
Alison G Hoppin, MD

INTRODUCTION

The majority of foreign body ingestions occur in children between the ages of six months and three years. Most cases are brought to medical attention by their parents because the ingestion was witnessed or reported to them. Many of the children are asymptomatic or have transient symptoms at the time of the ingestion. Clinical management focuses on identifying and treating the cases at risk for complications, which depends on the location and type of foreign body.

The diagnosis and management of foreign bodies in the esophagus are discussed here. Concerns specific to ingestion of button batteries (disk batteries) are discussed in greater detail separately. Management of gastric bezoars is discussed elsewhere. (See "Button and cylindrical battery ingestion: Clinical features, diagnosis, and initial management" and "Gastric bezoars".)

EPIDEMIOLOGY AND PATHOPHYSIOLOGY

Of more than 100,000 cases of foreign body ingestion reported each year in the United States, 80 percent occur in children [1-4]. The majority of foreign body ingestions occur in children between the ages of six months and three years [1,5,6]. Ingestion of multiple foreign objects and repeated episodes are uncommon occurrences and usually occur in children with developmental delay or behavioral problems [7,8]. Fortunately, most foreign bodies that reach the gastrointestinal tract pass spontaneously. Only 10 to 20 percent require endoscopic removal, and less than 1 percent require surgical intervention [1,5,9]. Although mortality from foreign body ingestion is extremely low, deaths have been reported [5,10,11].

Common foreign bodies — Commonly ingested objects include coins, button batteries, toys, toy parts, magnets, safety pins, screws, marbles, bones, and food boluses [2,7,9,12,13].

Coins – Coins are by far the most common foreign body ingested by children [1,14-18].

                           

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Literature review current through: Jul 2017. | This topic last updated: Mar 16, 2017.
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