Presentation
Mother concerned that a foreign body has been ingested.
Patient Data
A foreign body at the level of T8.
No pneumomediastinum or pneumothorax.
The airway is patent.
Case Discussion
There was no change in the position of the foreign body after 8 hours. A Mickey Mouse keyring was finally retrieved with oesophagoscopy.
Foreign body ingestion in children is a common ED presentation. If not removed, metallic/caustic material (e.g. battery) can erode into the esophagus, causing ulceration or even perforation. If passed into the stomach, most round foreign bodies cause little problem.
The most common parts of the esophagus for foreign bodies to lodge in are:
- cricopharyngeal muscle
- aortic knob
- gastro-esophageal junction
Follow-up examinations to look for passage of foreign bodies are essential, especially if they are pointed, long, irregular or jagged.
Credit: Dr Lily Wang.