Foreign body ingestion

概述 
理论 
诊断 
治疗 
随访 
资源 

最后审阅： 16 Feb 2026

最后更新： 14 Feb 2023

Foreign body ingestion is a common clinical problem. Those at increased risk include children, older people, people who have an intellectual disability, patients with psychiatric pathologies, prisoners/inmates, and those with underlying gastrointestinal (GI) mechanical obstruction.

Most ingested foreign bodies will pass through the GI tract without symptoms and cause only minor mucosal injury. However, 10% to 20% of cases will require some kind of nonoperative intervention, and 1% or less of cases may develop complications (e.g., bowel obstruction, perforation, severe hemorrhage, abscess formation, or septicemia) and require further surgical interventions.

Endoscopy is considered the first-line intervention for removal of foreign bodies. It is also considered the safest and most reliable method of diagnosis and treatment of foreign bodies in the GI tract.

Other nonoperative techniques for foreign body removal include the use of laryngoscopy, Foley catheters, and esophageal bougienage. Laparoscopic or open surgery is the last resort when other techniques have failed.

定义

An ingested foreign body is any object (including food) originating outside the body and ingested via the mouth into the GI tract.

病史和体格检查

关键诊断因素

dysphagia
nonspecific abdominal pain
stridor and wheezing
drooling

完整详情

其他诊断因素

gagging, nausea/vomiting, neck/throat pain
atypical chest pain or noncardiac chest pain
choking
lower gastrointestinal bleeding
pain on swallowing
fever, poor feeding, failure to thrive, and irritability (in children)
acute or chronic asthma-like symptoms or recurrent pneumonia
signs of sepsis
sign of acute drug intoxication

完整详情

危险因素

age <15 years
male sex (adults)
gastrointestinal tract narrowing
chemical dependence
intellectual disability
mental illness
inmates or people engaged in criminal activities
dental disorders
hurried eating
impaired gag reflex
history of underlying esophageal disease, surgery, or procedure
seizure disorder

完整详情

诊断性检查

首要检查

x-rays of neck, chest, abdomen
CBC
basic metabolic panel
prothrombin time (PT)/INR, PTT
handheld metal detector

完整详情

需考虑的检查

cardiac biomarkers and ECG
CT of neck, chest and/or abdomen
MRI
laryngoscopy
endoscopy

完整详情

治疗流程

初步治疗

unstable patients

急症处理

stable patients: oropharyngeal foreign body

stable patients: esophageal or rectal foreign body (excluding multiple magnets and batteries)

stable patients: esophageal or rectal foreign body - multiple magnets

stable patients: esophageal or rectal foreign body - batteries

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope (excluding multiple magnets and batteries)

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope - multiple magnets

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope - batteries

撰稿人

作者

Brian M. Fung, MD

Gastroenterology Fellow

Division of Gastroenterology and Hepatology

Department of Internal Medicine

University of Arizona College of Medicine - Phoenix

Phoenix

利益声明

BMF is the author of one reference cited in this topic.

鸣谢

Dr Brian M. Fung and Dr James H. Tabibian would like to gratefully acknowledge Dr Andrew C. Meltzer, Dr Juan Carlos Munoz, and Professor Luis F. Laos, previous contributors to this topic.

利益声明

ACM, JCM, and LFL declare that they have no competing interests.

同行评议者

Prakash Adhikari, MBBS, MS

Consultant

Ganesh Man Singh Memorial Academy of ENT and Head and Neck Studies

TU Teaching Hospital

Maharajgunj

Kathmandu

Nepal

利益声明

PA declares that he has no competing interests.

Jose Fernando Aycinena, MD

General Surgery Chief Resident

Department of General Surgery

University of Tennessee Medical Center

Knoxville

利益声明

JFA declares that he has no competing interests.

Richard V. Schaller, Jr, MD

Clinical Research Fellow

Cleveland Clinic Florida

Weston

利益声明

RVS declares that he has no competing interests.

David J. Hackam, MD, PhD

Associate Professor of Pediatric Surgery

University of Pittsburgh School of Medicine

Pittsburgh

利益声明

DJH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015 Apr;60(4):562-74.全文摘要

Gracia C, Frey CF, Bodai BI. Diagnosis and management of ingested foreign bodies: a ten-year experience. Ann Emerg Med. 1984 Jan;13(1):30-4. 摘要

Wai Pak M, Chung Lee W, Kwok Fung H, et al. A prospective study of foreign-body ingestion in 311 children. Int J Pediatr Otorhinolaryngol. 2001 Apr 6;58(1):37-45. 摘要

Thabet MH, Basha WM, Askar S. Button battery foreign bodies in children: hazards, management, and recommendations. Biomed Res Int. 2013;2013:846091.全文摘要

Ghahremani GG. Foreign bodies of the alimentary tract. In: Gore RM, Levine MS, Laufer I, eds. Textbook of gastrointestinal radiology. Philadelphia, PA: WB Saunders; 1994:2547-58.

Ikenberry SO, Jue TL, Anderson MA, et al; ASGE Standards of Practice Committee. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011 Jun;73(6):1085-91.全文摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

鉴别诊断
- Epiglottitis/supraglottitis (in children)
- Peritonsillar abscess (in children)
- Pyloric stenosis or hypertrophic pyloric stenosis (in children)
更多鉴别诊断
指南
- Foreign body ingestion
- Paediatric gastrointestinal endoscopy
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Foreign body ingestion

小结

定义

病史和体格检查

关键诊断因素

其他诊断因素

危险因素

诊断性检查

首要检查

需考虑的检查

治疗流程

unstable patients

stable patients: oropharyngeal foreign body

stable patients: esophageal or rectal foreign body (excluding multiple magnets and batteries)

stable patients: esophageal or rectal foreign body - multiple magnets

stable patients: esophageal or rectal foreign body - batteries

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope (excluding multiple magnets and batteries)

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope - multiple magnets

stable patients: foreign body in the stomach, proximal small bowel, or beyond reach of endoscope - batteries

撰稿人

作者

Brian M. Fung, MD

利益声明

鸣谢

利益声明

同行评议者

Prakash Adhikari, MBBS, MS

利益声明

Jose Fernando Aycinena, MD

利益声明

Richard V. Schaller, Jr, MD

利益声明

David J. Hackam, MD, PhD

利益声明

Peer reviewer acknowledgements

Disclosures

参考文献

关键文献

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

鉴别诊断

指南

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