List commonly ingested sharp objects.
Chicken bones
Fish bones
Straight pins
Paperclips
Open safety pins
Toothpicks
Describe the pathophysiology.
High risk of mucosal injury and perforation of the gastrointestinal tract
What are clinical features.
Immediate symptoms following ingestion: choking, drooling, cyanosis, inability to swallow, retrosternal pain
Esophageal perforation: swelling, subcutaneous crepitus
Describe diagnostics.
History of witnessed or self-reported ingestion
X-ray
Most metal objects are radiopaque
Radiolucent objects include plastic parts, wooden toothpicks, some fish bones
CT scan: to identify radiolucent or small FBs not detected on x-ray and assess surrounding tissue
Describe the management.
Emergency endoscopic removal (< 2 hours) is indicated if the sharp object located in the esophagus or the stomach with signs of obstruction or perforation
Urgent endoscopy removal (< 24 hours) is indicated if the sharp object is located in the esophagus (without severe symptoms) or in the stomach/duodenal bulb in asymptomatic patients
Describe the complications.
Esophageal perforation
Gastric perforation
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