What is included in the long-term monitoring following a pediatric foreign body ingestion?

Updated: Oct 04, 2018
  • Author: Gregory P Conners, MD, MPH, MBA, FAAP, FACEP; Chief Editor: Dale W Steele, MD, MS  more...
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Answer

See the list below:

  • After an esophageal foreign body is removed, children with uncomplicated courses do not need to undergo further evaluation.

  • A healthy child with repeated foreign body impaction or impaction at an unusual site should be evaluated for an underlying esophageal disorder.

  • Most children with foreign bodies in the stomach or lower GI tract have no complications and may be safely discharged from the emergency department. Caregivers of discharged children should be alerted to return if signs or symptoms of the occasional complication (eg, abdominal pain or distention, hematochezia, unexplained fevers, constipation, vomiting) develop.

  • Patients with known abnormalities of the GI tract, previous problems with foreign bodies, or unusual foreign bodies may require special treatment.

  • In general, straining of the stool for the foreign body is unnecessary.

  • Except in special instances, serial radiographs to document progress are unnecessary. This would be most useful if the results would be used to direct therapy, such as prolonged gastric retention of zinc coins, which may be indications for gastroscopic removal. Button batteries remaining in the stomach for 4 or more days, especially if associated with symptoms or if the battery is ≥15 mm in diameter in a child younger than 6, should be considered for removal. [15, 33]

  • The continued presence of a metallic foreign body may be documented by serial metal detector scans.


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