Dealing with swallowed objects in children

Some swallowed objects can cause problems or are likely to cause problems and these objects will need to be removed from the digestive tract by a doctor.

Children are more likely than adults to swallow objects. Children commonly swallow things such as coins, small toys, or batteries. Sometimes, adults swallow objects. This is more likely to happen when people are drunk, have loose dentures, or have certain brain disorders.

When a person swallows an object, the object travels through the person’s digestive tract. The digestive tract is made up of the oesophagus (the tube from the mouth to the stomach), stomach, small intestine, and large intestine. Most swallowed objects travel through and leave the body in a bowel movement (faeces) without causing problems.

Some swallowed objects can cause problems or are likely to cause problems and these objects will need to be removed from the digestive tract by a doctor.

If one thinks that a child has swallowed a small battery such as a watch battery, they should go to the nearest hospital emergency department immediately, and one must NOT try to induce vomiting.  This is because if a button battery is swallowed and becomes stuck in the oesophagus (food pipe), it can burn through tissue in just two hours, causing severe injury or even death.

Magnets too, can be dangerous when swallowed especially if two or more are swallowed.

Magnets can be dangerous when swallowed, especially if two or more are swallowed.

Most children have no symptoms after swallowing an object, and the object will not cause any problems.

Occasionally, the swallowed object can become stuck in the oesophagus and the child might experience symptoms like trouble swallowing food, drooling, pain in the neck or chest, coughing, trouble breathing, or noisy breathing.

Usually, the symptoms last as long as the object is stuck. But sometimes, the symptoms go away even though the object is still stuck.

Very rarely, the object can pass through the oesophagus and get stuck in the stomach or intestines. Hence, a child with vomiting, tummy pain, blood in their vomit or stool or a fever after swallowing an object needs emergency medical attention.

It is very important to know that if a child is coughing or having difficulty breathing, the object may be in their airway or lungs and this is a very serious life threatening condition which needs immediate medical attention.

At the hospital, the doctor will ask about the object and how long ago it was swallowed. He or she will also ask about symptoms as well as doing a physical exam.

Depending on the object and the person’s symptoms, the doctor might order X-rays of the neck, chest, or belly. Swallowed objects made out of certain materials can show up on the X-rays.

The X-rays help show where the object is inside one’s body. Usually, swallowed objects are in the digestive tract. An X-ray will also help to confirm if the object isn’t in the airway.

Some objects need to be removed from the body, but others don’t, depending on many factors such as; type of object swallowed, where the object is stuck, symptoms caused to the individual and how long the person has had it.

If the object doesn’t need to be removed, the doctor or nurse will have you check the child’s bowel for the object in the stool or observe the baby for any of the symptoms (abdominal pain, vomiting, blood in their vomit or faeces, and fever) which need intervention.

The child might have another follow up X-ray to confirm if the object came out.

To remove an object from the oesophagus or stomach, the doctor will do a procedure called an upper endoscopy. During this procedure, the doctor will put a thin tube with a camera and light on the end (called an endoscope) into the person’s mouth. He or she will move the tube down into the oesophagus, stomach, and duodenum (the first part of the small intestine) to look for the object. Then he or she can use special tools to grab the object and pull it out through the person’s mouth.

To remove an object from the intestines, the doctor might need to do surgery.

Dr Ian Shyaka,
Resident in Plastic Surgery, Rwanda Military Hospital