Michelle Kiser, a pediatric surgeon at Mission Children’s Hospital, offers expert advice on what to do when your child swallows a foreign object, as seen in WNC Parent.
More than 100,000 cases of ingested foreign bodies in children are reported to the American Association of Poison Control Centers annually, with about 70 percent occurring in children younger than 6.
By far what we see and treat as pediatric surgeons and gastroenterologists are small children who swallow coins. Other objects that are swallowed include: small toys, marbles, batteries, erasers, and sharp objects such as fish and chicken bones, pins, needles, jewelry, toothpicks, nails and paperclips.
Reports suggest more than 80 percent of foreign bodies will pass spontaneously through the gastrointestinal tract, while the rest require an intervention for removal. Intervention, which varies depending on the location of the foreign body, is usually required in those who are symptomatic. Foreign objects stuck in the esophagus usually result in refusal to eat, drooling or gagging, and are almost always removed endoscopically (with a camera through the mouth). Objects in the small or large intestine will usually pass through, but when they are symptomatic (i.e., bowel obstruction or perforation) they require an operation to remove.
Batteries and magnets
Operations are more frequently required for things such as batteries or magnets. For example, “button” batteries, especially the 20mm lithium batteries, if lodged in the esophagus, can cause tissue damage and lead to perforation within hours. If they make it to the stomach, they are usually fine to pass through the GI tract without causing significant damage. About 66,000 emergency room visits per year are the result of button battery ingestions in children younger than 18.
If you think your child swallowed more than one magnet, seek medical care immediately. Magnets pose a specific risk for bowel perforation when more than one magnet is ingested and the magnets are drawn to each other while in separate loops of the bowel. Keep in mind that magnets are often put in toys, and decorative and organizational items.
When to call for help
If you know that your child has swallowed something hazardous, you should contact your child’s pediatrician. The doctor may get an X-ray to determine the location of the object before making a decision whether to wait for it to pass or refer to a pediatric surgeon or gastroenterologist. If the child shows signs of coughing, gagging, drooling, vomiting, has chest or stomach pain, or has problems going to the bathroom, contact your pediatrician, go to the emergency department or call 911.
Keeping dangerous ingestible items out of reach of young children is the key to keeping them safe. These items should be kept up high out of reach and put away out of sight — this includes your loose change.
Don’t leave hazardous items out on counters and walk away, even for a few seconds. Make sure your children are playing with age-appropriate toys, and broken toys should be carefully cleaned up with all pieces — especially batteries — accounted for.
Michelle Kiser is a pediatric surgeon at Mission Children’s Hospital.