Toys and beads composed of superabsorbent polymers (original size 1mm-1cm) are designed to expand when placed in water so can expand following ingestion when contact is made with gastrointestinal fluids introducing the risk of pyloric or more distal obstruction. Superabsorbent polymers (expandable foreign bodies) Ulceration and indentation of the mucosa may occur within eight hours. Magnets pose a risk if ingested in multiples or with other ferrous objects (including batteries) as they may attract across layers of bowel leading to pressure necrosis, fistula development, volvulus, perforation, infection or obstruction. Spent batteries greater than 15mm diameter may still have sufficient residual charge to cause injury. Despite prompt removal, the risk of injury can continue up to weeks post-ingestion due to residual alkali and weakened tissues. Further erosion of structures can result in fistulae (tracheo-oesophageal / into adjacent vessels). Oesophageal perforation has been reported within two hours of ingestion. where there is sufficient retained battery charge, hydrolysis and creation of hydroxide ions in adjacent tissues leads to mucosal burn at battery’s negative pole.There are two main mechanisms by which button batteries can cause necrosis: A denial of ingestion in a child of any age cannot exclude it. intestinal obstruction or injury if object lodges more distally (rare)įor the majority of cases with severe outcomes, diagnosis was delayed as the event was unwitnessed and the clinical presentation was non-specific.īe vigilant for the risk of button battery ingestion in a child presenting to ED.weight loss due to feeding difficulties or recurrent aspiration in delayed diagnosis.erosion of surrounding structures leading to tracheo-oesphageal or aorto-oesophageal fistula which can be fatal.oesophageal perforation from sharp foreign bodies which may present with neck swelling, crepitus +/- pneumomediastinum.complete or partial oesophageal obstruction in immediate phase.3 Impaction in other areas of the oesophagus may indicate underlying pathology.Ĭomplications of ingested foreign bodies include: Objects may lodge in areas of physiological narrowing in the oesophagus including the upper and lower oesophageal sphincter and level of aortic arch. An estimated 10-20% of objects require endoscopic removal with less than 1% needing further surgical intervention. While most foreign bodies (80%) that reach the gastrointestinal tract (GI) pass spontaneously, 1 those that become impacted are at risk of causing significant harm and even death. Older children and adolescents with psychiatric problems may intentionally ingest non-food items. Ingested foreign bodies are more common in the following children:Ĭommonly ingested objects include coins, small toys and household objects.
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