Removal by an appropriate method of a foreign body lodged in the throat, ear, nose, esophagus, stomach-intestine, or under the skin. Can be performed on an emergency or elective basis.
Indication
- Foreign body causing airway obstruction (frequently in children)
- Food piece, coin, battery, or magnet stuck in the esophagus
- Sharp, long, or hazardous objects such as batteries in the stomach or intestine
- Object stuck in the ear, nose, or throat
- Embedded foreign body in the skin or soft tissue (glass, metal, wood fragment)
- Superficial foreign body on the eye or cornea
Preparation
- A detailed history of the event and the type of object are obtained
- Vital signs and the airway are evaluated as a priority
- Physical examination and appropriate imaging (X-ray, CT before endoscopy) for localization
- If endoscopy is planned, IV access, monitoring, and sedation preparation are arranged
How it's performed
- For complete airway obstruction in a conscious adult/child, the Heimlich maneuver is applied; in infants, 5 back blows and 5 chest compressions are performed
- Esophageal/gastric objects are removed via upper gastrointestinal endoscopy (button batteries in particular must be removed immediately)
- Small objects in the ear and nose are removed with appropriate forceps, hooks, or irrigation
- Objects in the skin and soft tissue are removed under local anesthesia with a small incision and exploration
- Superficial objects in the eye are removed with a cotton swab or needle tip after topical anesthesia
- The removed object is examined; tetanus and antibiotic prophylaxis are planned if needed
Post-procedure
- 1-2 hours of observation after the procedure; follow-up for symptom recurrence
- Several hours of fasting after endoscopy, followed by gradual feeding
- Wound care and a follow-up appointment if there are sutures
- Radiographic follow-up in subsequent days for battery or magnet cases
- Family education in children to prevent recurrence
Risks
- Esophageal or intestinal perforation
- Mucosal burn from battery contact
- Bleeding or infection
- The object slipping deeper during the procedure
- Adverse effects related to sedation
FAQ
My child swallowed an object — what should I do immediately?
If the child can breathe and speak, do not try to squeeze the throat; go to the nearest emergency department. If there is complete obstruction, perform the Heimlich maneuver in a child or 5 back blows + 5 chest compressions in an infant, and call 112.
Why is swallowing a button battery an emergency?
Button batteries can cause severe burns and perforation in the esophagus within hours; immediate endoscopy is required.
Should I try to remove an object stuck in the nose or ear at home?
Not recommended. The object may be pushed deeper or tissue may be injured. It should be removed by a physician with the appropriate instrument.
Does glass or metal embedded in the skin always have to be removed?
Most often yes. The location, depth, and proximity to vessels/nerves need to be evaluated; some small inert pieces may be left in place at the specialist's discretion.
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