Small children frequently ingest foreign bodies, most commonly coins and small toys. In an asymptomatic child who has ingested a small object without sharp projections or risk of systemic toxicity, observation is warranted. Parents should evaluate bowel movements for the presence of the object to ensure passage. Routine radiography may not identify plastic objects. Endoscopy should be reserved for the removal of sharp or potentially dangerous objects (eg, batteries) or for patients in distress or who cannot control their secretions, suggesting obstruction. Surgical consultation should be obtained if there is concern about perforation or if a dangerous object cannot be removed endoscopically. Barium should be avoided as it can coat the esophagus and complicate endoscopy if needed.
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Seminars in Medical Practice
Hospital Physician Board Review Manuals
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Updated 1/04/08 kkj