ingested foreign body (esophageal foreign body, coin ingestion)
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Etiology
- dysphagia
- most commonly due to stroke in the elderly
- eosinophilic esophagitis in young patients
- cancer
- stricture
- diverticulum
- Schatzky's ring
- experimential behavior in children
- coin ingestion
- magnet ingestion
- grill brush bristle ingestion
- fish bone (case report)[3]
Epidemiology
- older persons, especially with dementia
- children
Clinical manifestations
- difficulty handling secretions
- drooling
- leaning forward
- patients can often localize the level of the lesion by pointing to it
- inability to swallow
- regurgitation of food (no vomiting)
Radiology
- serial abdominal radiographs to ensure multiple magnets are progressing through the intestines[5]
Complications
- multiple magnets pose a unique risk when ingested together
Management
- patients with symptoms should always have obstructions removed as soon as possible
- for asymptomatic individuals with identifiable object (i.e. coin) in esophagus, observation may be appropriate
- conservative management for ingestion of a single magnet[5][6][7]
- for a child who has swallowed multiple magnets
- endoscopic foreign body removal is indicated for magnets in the esophagus or stomach
- if the magnets have moved beyond the stomach & are traveling together, & the patient is asymptomatic, the magnets may be followed with serial radiographs
- if the magnets are not progressing, foreign body removal via intestinal endoscopy or abdominal surgery indicated
More general terms
More specific terms
Additional terms
References
- ↑ Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
- ↑ 2.0 2.1 Waltzman ML, Baskin M, Wypij D, Mooney D, Jones D, Fleisher G. A randomized clinical trial in the management of esophageal coins in children. Pediatrics 2005 Sep; 116:614-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16140701
- ↑ 3.0 3.1 Gharib SD et al Case 21-2015 - A 37-Year-Old American Man Living in Vietnam, with Fever and Bacteremia. N Engl J Med 2015; 373:174-183. July 9, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26154791 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1411439
- ↑ Ahmadi MS, Ahmadi M. Missed Pharyngeal Foreign Body in an Infant that Persisted for 50 days:A Rare Case. Iran J Otorhinolaryngol. 2012 Summer;24(68):151. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24303402 Free PMC Article
- ↑ 5.0 5.1 5.2 5.3 5.4 NEJM Knowledge+ Question of the Week. Nov 14, 2017 https://knowledgeplus.nejm.org/question-of-week/4148/
- ↑ 6.0 6.1 6.2 Tavarez MM, Saladino RA, Gaines BA, Manole MD. Prevalence, clinical features and management of pediatric magnetic foreign body ingestions. J Emerg Med 2012 Jun 26; 44:261 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22727803
- ↑ 7.0 7.1 7.2 Wright CC, Closson FT. Updates in pediatric gastrointestinal foreign bodies. Pediatr Clin North Am. 2013 Oct;60(5):1221-39. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24093905