Pathway for the Evaluation/Treatment of the Child with Foreign Body Ingestion

Food Impaction
Suspected by History and PE
Symptoms
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EMERGENT ENDOSCOPIC REMOVAL
Normal Esophagus
Abnormal Esophagus
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Consult: GI, ENT
Consult: GI, General Surgery
Notify OR 4-5444
NPO, IVF
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No Symptoms
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URGENT ENDOSCOPIC REMOVAL
Normal Esophagus
Abnormal Esophagus
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Consult: GI, ENT
Consult: GI, General Surgery
CONSIDERATIONS
  • High incidence of underlying esophageal pathology
    • Stricture, achalasia, eosinophilic esophagitis
    • History of esophageal surgery (TEF repair)
  • UGI, esophagram not routinely indicated due to aspiration risk
  • Avoid use of proteolytic enzymes (meat tenderizer)
    • Associated with hypernatremia, esophageal perforation
  • Pushing food bolus blindly into the stomach can increase risk of perforation
Posted: July 2013
Authors: B. Sahn, MD, P. Mamula, MD, F. Henretig MD, J. Collins, MD, S. Sobol, MD, C. Ford, MD