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What to do when your child swallows an object
By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine
Young children and, sometimes, older children and adults may swallow toys, coins, safety pins,
Dr Zulfikar Bux
buttons, bones, wood, glass, magnets, batteries or other foreign objects. These objects often pass all the way through the digestive tract in 24 to 48 hours and cause no harm.
But problems may arise when objects are stuck for a long time, are sharp, or contain corrosive materials. Complications can include tears in the esophagus (the tube that connects the mouth and stomach), movement of the object into the tissue of the esophagus, and infection. Small magnets can pose a special problem. If more than one is swallowed, they can stick together and erode through tissue.
Three areas of the esophagus are the most likely places for objects to lodge:
- At the level of the collarbones (clavicles) — the most common place
- At the centre of the chest
- Just before the esophagus meets the stomach, near the bottom of the rib cage
Objects also may get stuck in any part of the esophagus that has been injured previously.
ARE THERE SYMPTOMS TO LOOK FOR?
Kids may sometimes swallow an object and not tell you. Looking for symptoms may be your only clue. If the object gets caught in the esophagus, it can cause:
- Drooling
- Inability to swallow or painful swallowing
- Vomiting
- Chest pain or neck pain
Objects also can become trapped in the intestine or can tear the intestinal walls. The result can be vomiting, abdominal pain, abnormal bowel sounds and dark stools that contain blood.
ARE THERE ANY TESTS TO SHOW A SWALLOWED OBJECT?
After your doctor examines your child and asks about his or her recent medical history, the doctor may order an X-ray to help show where the object is. Some things cannot be seen with an X-ray. If the X-ray does not show the object, but the symptoms and circumstances still suggest that an object is stuck in the esophagus, the child may need a computerized tomography (CT) scan, or other radiologic tests.
WHAT CAN YOU DO?
If your child has swallowed a foreign object, call your doctor for advice, and:
- Do nottry to make the child vomit.
- Do not
- Do notassume that surgery is necessary. Most objects pass through the digestive tract without complications. Surgery for removing foreign objects is not common.
- Do notforcefully remove the object. This can cause further injury.
Your doctor may want to take an X-ray to see where the battery is located and to make sure that it does not become lodged in the digestive tract. If your child has swallowed something sharp, such as a piece of glass or an open safety pin, contact your doctor, even if your child has no symptoms. Sharp objects sometimes can injure the esophagus, stomach or intestines.
If your child has swallowed a smooth object, such as a coin or a small stone, and has no symptoms, contact your doctor to decide the best course of action. You may be able to wait and see if the object passes through the digestive tract on its own. If more than 24 to 48 hours pass and you do not see the object in the toilet or in your child’s diaper, or if your child begins experiencing symptoms of a lodged object, contact your doctor.
WHAT IS THE PROGNOSIS LIKE?
In most cases the outlook is excellent; the object will pass on its own or can be removed without complications. Complications from a doctor removing the foreign object using a camera can include bleeding, tears in the esophagus or complications from the anesthesia. Complications of using a balloon tube to remove a foreign object include vomiting, short-term blockage of the airway and injury to the esophagus. However, these complications are rare.
As we always say, prevention is better than cure. As much as you can, avoid leaving small objects in the reach of small children, especially those less than 3 years of age. This is the best way to avoid the anxiety and sometimes complications that can be associated with a child swallowing an object.
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