Ingested foreign bodies in children

Ingested foreign bodies in children are common as the world is a curious place to young children, who will put anything and everything into their mouth, and will often inadvertently swallow. 

The usual practice is for plain films of the chest/abdomen to identify a foreign body.

The peak incidence of foreign body ingestion is between six months and six years 1

Approximately 50% of children will be asymptomatic 2

Coins are the most commonly ingested foreign body 3, along with toys, batteries, bones, and almost anything that can fit into a child's mouth. 

Standard radiographic investigation of foreign bodies in children should include plain radiographs of the neck, thorax and entire abdomen 4. In one study ~65% of ingested foreign bodies were radiodense 2.

As a rule of thumb, coins visualized in the sagittal plane (acquired while entering through vocal cords) on anteroposterior radiographs are in the trachea, whereas coins in the esophagus will have a coronal orientation on frontal chest radiographs.

An important alternative to consider when assessing coin-like objects are button batteries. These are very similar in appearance to coins, but typically have a slight step in profile with an inner ring when viewed en face.

Most foreign bodies make it into the stomach and beyond with up to 80% passing spontaneously 1.  

Button batteries can be potentially fatal when in contact with surrounding tissue as they can generate an electric current that will lead to the formation of sodium hydroxide resulting in severe, potentially fatal mucosal damage 5-7.  

Treatment with early and frequent ingestion of honey until endoscopic removal of the button battery has been found to significantly decrease the rates of outward mucosal injury and full thickness tissue necrosis8.

 

Share article

Article information

rID: 31003
Section: Gamuts
Synonyms or Alternate Spellings:
  • Paediatric foreign body ingestion

Support Radiopaedia and see fewer ads

Cases and figures

  • Case 1
    Drag here to reorder.
  • Case 2: magnets
    Drag here to reorder.
  • Case 3
    Drag here to reorder.
  • Case 4: marble
    Drag here to reorder.
  • Case 5: ring
    Drag here to reorder.
  • Case 6: nail
    Drag here to reorder.
  • Case 7
    Drag here to reorder.
  • Case 8: pen
    Drag here to reorder.
  • Upside down "Spon...
    Case 9: Spongebob Squarepants
    Drag here to reorder.
  • Case 10: Mickey Mouse
    Drag here to reorder.
  • Rounded radio opa...
    Case 11
    Drag here to reorder.
  • The vertebral col...
    Case 12
    Drag here to reorder.
  • Case 13: button battery in esophagus
    Drag here to reorder.
  • Case 14: magnets
    Drag here to reorder.
  • Case 15: with situs inversus
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.