What type of swallowed foreign bodies need to be removed, and which can be pooped out?

You may have read the recent case of a child in Florida who swallowed a battery.  His parents were advised that he would “poop it out’, but the child ended up having complications, and requiring multiple surgeries.

This leads to the question of the day:  What type of swallowed foreign bodies need to be removed, and which can be pooped out?

Swallowed foreign objects occur mostly in patients from age 6  months to 6 years.  In adults, swallowed foreign bodies can occur if accidentally ingested with food, or in patients with mental disorders.  In the United States, 1500 people die from ingested foreign bodies each year!

Overall, 80% of foreign objects can be pooped out with no medical intervention!  However, about 19% need to be removed endoscopically (with a tube), and 1% of patients will need to have the foreign object removed by surgery.

The most commonly ingested foreign bodies in adults are fish bones (45%), meat bones (40%), and dentures (5%).  Other more rare foreign bodies make up the remainder.

In children, coins are the most commonly found foreign object, followed by sewing pins, safety pins and hair clips.

If a sharp object is in the esophagus as shown by x-ray studies, it must be removed.  But if it has already passed out of the esophagus, it will usually pass on it’s own, even safety pins!  There is a Golden Rule in medicine that if an object is longer than 6 cm with diameter of more than 2.5 cm, it will likely NOT pass on its own.  If a patient has pain or vomiting after swallowing a foreign object, further investigation is always warranted.

Button batteries pose a special risk in children, as they cause an alkaline reaction, and can result in serious internal burns.  In the United States, a child swallows a button battery every 3 hours!

Whenever a foreign body is accidentally swallowed, a call to the doctor is important to determine the next best step.

Ingested button battery in child: