Pathway for the Evaluation/Treatment of the Child with Foreign Body Ingestion
Ingestion of Sharp Object
Main Pathway
Foreign Body
Ingestion Pathway
Foreign Body
Ingestion Pathway
Esophagus
Emergent
Endoscopic Removal
Endoscopic Removal
Consult ENT
ENT will consult GI as needed
ENT will consult GI as needed
NPO, IVF
Alert OR 5-4444
Alert OR 5-4444
Stomach/Duodenum
Consult GI
Symptoms
or
Length ≥ 3 cm
Width ≥ 2 cm
or
Length ≥ 3 cm
Width ≥ 2 cm
No Symptoms
and
Length < 3 cm
Width < 2 cm
and
Length < 3 cm
Width < 2 cm
Urgent
Endoscopic Removal
Endoscopic Removal
Consider Consult
General Surgery
General Surgery
Discharge
Follow-up X-ray2-3 days
Beyond Duodenum
Consult GI
Symptoms
No Symptoms
Admit
Consult General SurgeryDischarge
Follow-up X-ray2-3 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