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Foreign Body Ingestion — Ingestion of Sharp Object — Clinical Pathway: Emergency, ICU and Inpatient

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

Ingestion of Sharp Object
 
Esophagus
Emergent
Endoscopic Removal
Consult ENT
ENT will consult GI as needed
NPO, IVF
Alert OR 5-4444
Stomach/Duodenum
Consult GI
Symptoms
or
Length ≥ 3 cm
Width ≥ 2 cm
No Symptoms
and
Length < 3 cm
Width < 2 cm
Urgent
Endoscopic Removal
 
Consider Consult
General Surgery
Discharge
Follow-up X-ray
2-3 days
Beyond Duodenum
Consult GI
Symptoms
No Symptoms
Admit
Consult General Surgery
Discharge
Follow-up X-ray
2-3 days
Non-radiopaque Sharp FB Suspected
  • UGI
    • Case-by-case decision after discussion w/consultant
    • May obscure visualization of object on endoscopy
    • May increase risk of aspiration
  • Endoscopy preferred
  • CT scan considered in special circumstances
 
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