Foreign Body Ingestion and Aspiration

• Foreign body aspirations frequently are missed on initial evaluation, and delay in diagnosis is associated with increased risk for complications. Specific questioning regarding choking episodes is crucial. • Plain film radiography often is helpful in the diagnosis and localization of foreign bodies. However, studies suggest that sensitivity varies, and additional evaluation must be undertaken if clinical suspicion exists and the films are normal. • Evidence is strong that gastric foreign bodies can be observed in the outpatient setting if the child has no GI abnormalities. Esophageal objects are unlikely to pass, although studies suggest that many coins progress without intervention. • Many reports indicate that ingestion of button batteries, sharp and elongated objects, and magnets require extra caution because they are more likely to create complications. Esophageal button batteries pose an especially urgent problem and can cause complications that may develop within hours. Children in whom the batteries are in the stomach can be monitored as outpatients. Copyright © 2009 by the American Academy of Pediatrics. All rights reserved.