Introduction:
Children swallowing buttons, coins, screws, pins, etc any other objects are common in infants and toddlers between 6 months – 3 years of age, as they have a curiosity and natural tendency to explore things by putting them in mouth.
The risk of aspiration in airway is common in children when they are eating groundnuts, almonds etc without properly chewing them especially during crying or talking.
Symptoms:
The symptoms of a swallowed Foreign Body (FB) are usually hard to miss. You’ll notice symptoms immediately if the object blocks the airway. The most common symptoms include choking, difficulty breathing, coughing, wheezing. If a child swallows a FB easily and if it doesn’t get stuck in their throat, there may not be any immediate symptoms. Possible symptoms that occur when an item is stuck in the oesophagus or bowel include: vomiting, drooling of saliva, gagging, throat / chest pain, refusal to eat, abdominal pain, fever.
Diagnosis:
A FB stuck for a long time in airway can cause infection, such as recurrent aspiration pneumonia. This may result in chest pain, recurrent cough, fever and wheezing. They can be better understood based on the visibility in the X-ray, or sometimes CT scan.
Treatment
If these foreign bodies are of smaller size and enter airway, child may need admission in Paediatric emergency/ Intensive Care Unit. FB in airway is removed by bronchoscopy under anaesthesia. Unfortunately, few severe cases may land upon ventilator/ may need tracheostomy. If FB enter digestive tract or the gastrointestinal tract (GI) they are more likely to pass through, without causing any serious problems. Simple foreign bodies like coin, buttons, hair pin etc can be removed via endoscopy. Flexible endoscopy is the best approach to remove these foreign objects and are performed safely under anaesthesia. However, if the objects are large, sharp, and irregular shaped, they can perforate the GI tract while passing through the digestive tract, which may even lead to adhesion (in case of magnets) and cause symptoms. Therefore, these high-risk foreign bodies are removed via surgery.
Conclusion:
Foreign body ingestion/aspiration is common and sometimes unavoidable. Overall, parents need not panic when they get to know that their child has swallowed a foreign body. Keep calm and try not to pull the object out from the throat, as it is not possible and may lead to laryngeal injuries. If child is coughing/ difficulty in breathing rush your child to a nearby paediatric emergency room or paediatric surgeon. In case of a button battery, one can use 2-3 tablespoons of honey immediately, which is believed to reduce the risk of damage. However, a foreign object left in the body could cause an infection or damage organs. It’s best to check in with your doctor and seek proper advice before it’s too late.
Dr. Swapnil Pattanshetti
Associate Professor, Dept. of Paediatric surgery, JNMC, Belagavi.
Consultant Paediatric Surgeon, KLES Hospital, Belagavi.
