EM · Foreign body ingestion and aspiration

Foreign body ingestion and aspiration — coins, button batteries, magnets and the choking child

Also known as Button battery ingestion · Coin ingestion · Magnet ingestion · Foreign body aspiration · Inhaled foreign body · Choking child · Ingested foreign body

Foreign body ingestion and aspiration — the two anatomic compartments and the time-critical objects. Ingestion: coins (oesophageal impaction at the three physiological narrowings, urgent oesophagogastroduodenoscopy), button battery (an EMERGENCY — electrolysis and liquefaction necrosis of the oesophageal wall within hours, oesophagogastroduodenoscopy within 2 hours, the double-ring and halo sign on X-ray, honey and sucralfate as a bridge, aortoesophageal fistula as the lethal complication), and magnets (attraction across bowel walls with pressure necrosis, perforation and fistula — emergency removal when two or more are present). Aspiration: sudden choking, stridor, monophonic or fixed wheeze, and asymmetric air entry, distinguished from croup, epiglottitis and asthma, with back blows and chest thrusts for the choking infant (abdominal thrusts for the child over one year) and rigid bronchoscopy as the gold standard. ACEM-primary, globally tagged.