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

Multiple Magnets Confirmed on X-Ray
Esophagus
Stomach
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EMERGENT ENDOSCOPIC REMOVAL
Consult: GI, ENT
NPO, IVF
Notify OR 4-5444
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Consult
General Surgical
(OR Back-up)
Consult
General Surgery
  • For ingestion > 12 hours
  • Fail to remove magnets
Beyond the Stomach*
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Symptoms
No Symptoms
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Consult:
General Surgery
GI
Admit for removal
Consult:
GI
General Surgery
Admit GI
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TREATMENT OPTIONS IF NO SYMPTOMS
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Laxative to aid passage
Serial X-ray 4-6 hours
Serial abdominal exams
Endoscopic Removal
Consult General Surgery
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Observe 48 Hrs
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No Progression on X-ray
Progression on X-ray
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Colonoscopy
Surgical Consult
Continue serial X-ray
All magnets passed
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Observe Feeding Tolerance
*If symptoms develop, prepare for immediate removal
MAGNET PRECAUTIONS
  • Remove all metallic, magnetic objects from patient's environment
  • Assure no magnets, metal on patient's clothing (buckles, snaps, buttons)
  • Assure no magnets available for ingestion
  • Continue until magnets are passed
Posted: July 2013
Authors: B. Sahn, MD, P. Mamula, MD, F. Henretig MD, J. Collins, MD, S. Sobol, MD, C. Ford, MD