Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- dysphagia
- nonspecific abdominal pain
- stridor and wheezing
- drooling
Otros factores de diagnóstico
- 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
Factores de riesgo
- age <15 years
- male sex (adults)
- gastrointestinal tract narrowing
- chemical dependence
- intellectual disability
- mental illness
- inmates or people engaged in criminal activities
- dental disorders and use of dentures
- hurried eating
- impaired gag reflex
- history of underlying esophageal disease, surgery, or procedure
- seizure disorder
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- x-rays of neck, chest, abdomen
- CBC
- basic metabolic panel
- prothrombin time (PT)/INR, PTT
- handheld metal detector
Pruebas diagnósticas que deben considerarse
- cardiac biomarkers and ECG
- CT of neck, chest and/or abdomen
- MRI
- laryngoscopy
- endoscopy
Algoritmo de tratamiento
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
Colaboradores
Autores
Brian M. Fung, MD
Gastroenterologist
Arizona Digestive Health
Mesa, AZ
Divulgaciones
BMF is the author of one reference cited in this topic.
Agradecimientos
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.
Divulgaciones
ACM, JCM, and LFL declare that they have no competing interests.
Revisores por pares
James C. Crosby, MD, FACEP
Assistant Professor of Emergency Medicine
University of Alabama at Birmingham
Birmingham, AL
Divulgaciones
JCC declares that he has no competing interests.
Prakash Adhikari, MBBS, MS
Consultant
Ganesh Man Singh Memorial Academy of ENT and Head and Neck Studies
TU Teaching Hospital
Maharajgunj
Kathmandu
Nepal
Divulgaciones
PA declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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.Texto completo Resumen
Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy. 2016 May;48(5):489-96.Texto completo Resumen
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.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Epiglottitis/supraglottitis (in children)
- Peritonsillar abscess (in children)
- Pyloric stenosis or hypertrophic pyloric stenosis (in children)
Más DiferencialesGuías de práctica clínica
- ACR appropriateness criteria ingested or aspirated foreign body-child
- Foreign body ingestion
Más Guías de práctica clínicaInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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