Foreign Body Ingestion

Question 1

When to do urgent endoscopy?

Answer 1

When foreign body has stayed for >24 hours

Question 2

When is glucagon indicated?

Answer 2

For objects lodged at distal esophagus
Glucagon 1-2 mg IV

Question 3

most common lodged food

Answer 3

Meat
- should not be allowed to remain impacted for >12-24 hours
- note that proteolytic enzymes are contraindicated

Question 4

Remarks on button battery ingestion

Answer 4

1. Perforation can occur within 6 hours
2. If esophageal localization is noted radiographically, do immediate endoscopy if available
3. If beyond esophagus, do repeat films at 48 hours

Question 5

When to consider foley balloon catheter removal of button battery?

Answer 5

If at esophagus,
if endoscopy is not immediately available,
and if there’s reliable history of ingestion within 2 hours

Question 6

Remarks on sharp objects ingestion

Answer 6

1. Perforation is common past stomach
2. And so, perform endoscopy while sharp object is still in stomach/duodenum
3. Surgical removal should be considered if sharp object has not passed after 3 days

Question 7

Remarks on narcotic carriers

Answer 7

1. Endoscopy is contraindicated
2. Mgt: observation or whole bowel irrigation