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Foreign object - inhaled or swallowed

Definition

If you breathe a foreign object into your nose, mouth, or respiratory tract, it may become stuck and cause breathing problems or choking. It can also lead to inflammation and infection.

If you swallow a foreign object, it can get stuck along the gastrointestinal (GI) tract. This can lead to an infection or blockage or tear in the GI tract.

Alternative Names

Obstructed airway; Blocked airway

Considerations

Children age 1 to 3 are most like to swallow or breathe in a foreign object. These items may include a coin, marble, pencil eraser, buttons, beads, or other small items or foods.

Causes

Young children can easily breathe in certain foods (such as nuts, seeds, and popcorn) and small objects (such as buttons and beads). This may cause a partial or total airway blockage.

If the object passes through the esophagus (food pipe) and into the stomach without getting stuck, it will probably pass through the entire GI tract.

Symptoms

Symptoms include:

  • Choking
  • Coughing
  • No breathing or breathing trouble (respiratory distress)
  • Wheezing

Sometimes, only minor symptoms are seen at first. The object may be forgotten until symptoms such as inflammation or infection develop.

First Aid

FOR AN INHALED OBJECT

Any child who may have breathed in (inhaled) an object should be seen by a doctor. Children with obvious breathing trouble may have a total airway blockage that requires emergency medical help.

If choking or coughing goes away, and the child does not have any other symptoms, he or she should be watched for signs and symptoms of infection or irritation. X-rays may be needed.

Bronchoscopy may be needed to confirm the diagnosis and to remove the object. Antibiotics and breathing therapy may be needed if an infection develops.

FOR A SWALLOWED OBJECT

Any child who is believed to have swallowed a foreign object should be watched for pain, fever, vomiting, or local tenderness. Stools (bowel movements) should be checked to see if the object has passed through the body. This may sometimes cause rectal or anal bleeding.

Sharp objects, such as pins and screws, usually pass through the GI tract without complications. X-rays are sometimes needed, especially if the child has pain or the object does not pass within 4 to 5 days.

Esophagogastroduodenoscopy (EGD) may be needed to confirm the diagnosis and remove the object. This procedure involves placing a tube through the mouth into the GI tract.

In severe cases, surgery may be needed to remove the object.

Do Not

DO NOT force feed infants who are crying or breathing rapidly. This may cause the baby to inhale liquid or solid food into their airway.

When to Contact a Medical Professional

Call a health care provider or local emergency number (such as 911) if you think a child has inhaled or swallowed a foreign object.

Prevention

Preventive measures include:

  • Cut food into appropriate sizes for small children. Teach them how to chew well.
  • Discourage talking, laughing, or playing while food is in the mouth.
  • Do not give potentially dangerous foods such as hot dogs, whole grapes, nuts, popcorn, or hard candy to children under age 3.
  • Keep small objects out of the reach of young children.
  • Teach children to avoid placing foreign objects into their noses and other body openings.

References

Cukor J, Manno M. Pediatric respiratory emergencies. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 168.

Munter DW. Esophageal foreign bodies. In: Roberts JR, Hedges JR, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, PA: Elsevier Saunders; 2009:chap 39.

Thomas SH, Goodloe JM. Foreign bodies. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 60.

Review Date:1/12/2015
Reviewed By:Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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