Foreign Bodies Foreign body ingestion Foreign body aspiration a Toddlers Oral exploration Lack posterior dentition easy distractibility Cognitive development (edible?)
Foreign Bodies ◼ Foreign body ingestion ◼ Foreign body aspiration ◼ Toddlers ◼ Oral exploration ◼ Lack posterior dentition ◼ Easy distractibility ◼ Cognitive development (edible?)
Foreign body ingestion coins-75% Bones(mainly fish bone) Meat a Vegetable matter False teeth a Less than 24 hours in most
Foreign Body Ingestion ◼ Coins – 75% ◼ Bones (mainly fish bone) ◼ Meat ◼ Vegetable matter ◼ False teeth ◼ Less than 24 hours in most
Foreign body ingestion a Parental suspicion a Symptoms Choking, coughing, dysphagia, odynophagia a Physical exam Drooling, refuses p o, fussy child Respiratory compromise
Foreign Body Ingestion ◼ Parental suspicion ◼ Symptoms ◼ Choking, coughing, dysphagia, odynophagia ◼ Physical exam ◼ Drooling, refuses p.o., fussy child ◼ Respiratory compromise
Foreign body ingestion Common locations onsils Vallecula epiglottica Pyriform sinuses Cricopharyngeus Aorta/left mainstem bronchus Gastroesophageal junction
Foreign Body Ingestion ◼ Common locations ◼ Tonsils ◼ Vallecula epiglottica ◼ Pyriform sinuses ◼ Cricopharyngeus ◼ Aorta/left mainstem bronchus ◼ Gastroesophageal junction
Foreign body ingestion a Radiopaque coins Cartilage/bones Radiolucent Hot dogs Barium swallow
Foreign Body Ingestion ◼ Radiopaque ◼ Coins ◼ Cartilage/bones ◼ Radiolucent ◼ Hot dogs ◼ Barium swallow
Foreign Body Ingestion Barium swallow
Foreign Body Ingestion ◼ Barium Swallow
Foreign body ingestion Observation Recent ingestion Blunt object Endoscopy Complete obstruction Airway compromise Impacted Caustics Anomalies
Foreign Body Ingestion ◼ Observation ◼ Recent ingestion ◼ Blunt object ◼ Endoscopy ◼ Complete obstruction ◼ Airway compromise ◼ Impacted ◼ Caustics ◼ Anomalies
Foreign body ingestion Removal general anesthesia Intubated Esophagoscopy Examine for ulceration/perforation
Foreign Body Ingestion ◼ Removal ◼ General anesthesia ◼ Intubated ◼ Esophagoscopy ◼ Examine for ulceration/perforation
Foreign body ingestion Disc batteries Emergency NaOH, KOH, mercury 1 hour -mucosal damage 2 to 4 hours- muscular layers 8 to 12 hours- perforation Esophagoscopy Observation for gastric location for 4-7 days Laparotomy for bowel perforation
Foreign Body Ingestion ◼ Disc batteries ◼ Emergency ◼ NaOH, KOH, mercury ◼ 1 hour – mucosal damage ◼ 2 to 4 hours – muscular layers ◼ 8 to 12 hours – perforation ◼ Esophagoscopy ◼ Observation for gastric location for 4-7 days ◼ Laparotomy for bowel perforation
Foreign body ingestion Complication Perforation of esophagus Subcutaneous/mediastinal emphysema Mediastinal abscess Break of the aorta Esophageal fistula/ stricture
Foreign Body Ingestion ◼ Complication Perforation of esophagus Subcutaneous/mediastinal emphysema Mediastinal abscess Break of the aorta Esophageal fistula/stricture
