Foreign body ingestion occurs with any object that is small enough to pass into the mouth and be swallowed. This happens more often in children but can also happen in adults especially with food, like fish bones or medications. Most foreign bodies will pass on their own without any intervention. In children especially, some foreign bodies can be life-threatening if they obstruct the airways. In others, damage can occur to the windpipe and the digestive tract also.
Children that have ingested something can present with obvious choking or difficulty breathing, even turning blue in severe cases and losing consciousness if their airway is blocked. They may also present with drooling, wheezing, retching, vomiting, and difficulty eating or drinking.
Adults are much more able to verbalise that something is stuck and indicate where they think it is stuck so their common complaint is often pain or difficulty swallowing. If the obstruction is partial then the presentation is more insidious with repeated infections, fever, cough, poor appetite, or failure to grow as expected.
Foreign bodies should be dealt with by your nearest emergency department as soon as you are aware that it has happened and if it is causing you any symptoms or discomfort.
The transparency of the object will determine the correct investigation required to visualise it properly. If the object is not see-through then X-rays can be helpful. Thin objects like bones from food, metals, or plastic are not easily seen on X-rays. CT scans are helpful for showing up most kinds of foreign bodies. If there is any immediate obstruction the doctors may arrange an urgent endoscopy (camera down your throat) to locate and remove the blockage.
Sharp objects like toothpicks can cause ruptures or tears to the inner lining of the digestive tract. Batteries and metal objects can erode and damage the surrounding surface as well as causing metal poisoning if not removed quickly enough. It is important to seek urgent medical advice straight away if any of these or similar objects have been ingested. Foreign bodies that are not removed quickly can also lead to an infection, abscess, or a blockage depending on the size of the tube they are stuck inside.
It is really important that if there is any obstruction to the airway, an ambulance is called immediately. Children need to remain as calm as possible because any distress can cause worsening symptoms. If there is a life-threatening situation, an emergency procedure to open up the airways can be performed by emergency services. At the hospital, doctors can undergo a number of methods to open up the airway and remove the entrapped foreign body.
Patients who are stable and have no threat to their life will be reviewed, investigations may be arranged to locate the object and the patient will be followed up regularly to ensure there is no worsening of symptoms.
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