Swallowed Object (cont.)
Swallowed Object Treatment
The physician may conclude that the object swallowed only caused minor trauma to the throat or esophagus and ask the patient to eat or drink something. If this can be done without difficulty or pain, he or she may be discharged with instructions including warning signs of any complications.
If an object is seen in the back of the throat on visual inspection, the doctor may attempt to remove it. A local anesthetic can be sprayed to make removal more comfortable. The physician will simply grab the object with forceps and remove it.
If the object is seen around the area of the voice box, immediate removal is required. This procedure is rarely done in the emergency department. Commonly, an ear, nose, and throat specialist (ENT) removes the object in the short procedure unit or in the operating room.
Objects, including food, stuck in the esophagus must be removed. A gastroenterologist perform this using a fiber optic scope. No operation is needed. Occasionally, a foreign body in the upper esophagus can be removed by placing a catheter below the object. A balloon is then inflated, and the object is lifted out of the mouth.
For objects, especially food, stuck in the esophagus, medicine therapy may be tried. Medications such as nitroglycerine given under the tongue and glucagon given by IV can relax the esophagus and allow passage of the food to the stomach. An IV catheter is required for this. The success rate is is poor with this procedure.
Swallowed objects that make it to the stomach usually pass in the stool without difficulty. Special consideration must be given to objects such as button batteries and sharp objects such as pins and bones. These usually pass without consequence, but occasionally they get stuck somewhere in the digestive tract.
Thomas Rebbecchi, MD, FAAEM
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