Pathway for the Evaluation/Treatment of the Child with Foreign Body Ingestion
Multiple Magnets Confirmed on X-ray
Main Pathway
Foreign Body Ingestion Pathway
Foreign Body Ingestion Pathway
Esophagus
Stomach
Consult ENT
- ENT will consult:
- General Surgery for OR back-up
- GI as indicated
Consult GI
Emergent
Endoscopic Removal
Endoscopic Removal
Notify OR 5-4444
NPO, IVF
NPO, IVF
Beyond the Stomach
Symptoms
No Symptoms
Consult GI
Admit for removal
Admit for removal
Consult GI
Admit GI
Admit GI
Treatment Options if No Symptoms
- If symptoms develop, prepare for immediate removal
- Consider the following:
- Laxative to aid passage
- Serial abdominal exams
- Serial X-ray 4-6 hrs
- Note: Magnets moving on sequential X-rays may not represent true progression of magnet within a single lumen
- Removal procedure based on exam, magnet type, location
- Endoscopy
- Colonoscopy
- Surgery
Magnet Precautions
- Remove all metallic, magnetic objects from child's environment
- Ensure no magnets, metal on child's clothing
(buckles, snaps, buttons) - Ensure no magnets available for ingestion
- Continue until magnets are passed