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Foreign body ingestion

Última revisão das evidências: 20 Apr 2026
Última atualização do tópico: 14 Feb 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • dysphagia
  • nonspecific abdominal pain
  • stridor and wheezing
  • drooling
Detalhes completos

Outros fatores diagnósticos

  • 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
Detalhes completos

Fatores de risco

  • 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
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

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

Investigações a serem consideradas

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

Algoritmo de tratamento

Inicial

unstable patients

AGUDA

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

Gastroenterology Fellow

Division of Gastroenterology and Hepatology

Department of Internal Medicine

University of Arizona College of Medicine - Phoenix

Phoenix

AZ

Declarações

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

Agradecimentos

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.

Declarações

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

Revisores

Prakash Adhikari, MBBS, MS

Consultant

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

TU Teaching Hospital

Maharajgunj

Kathmandu

Nepal

Declarações

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

TN

Declarações

JFA declares that he has no competing interests.

Richard V. Schaller, Jr, MD

Clinical Research Fellow

Cleveland Clinic Florida

Weston

FL

Declarações

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

PA

Declarações

DJH declares that he has no competing interests.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

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  Resumo

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. Resumo

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. Resumo

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

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.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Foreign body ingestion images
  • Diagnósticos diferenciais

    • Epiglottitis/supraglottitis (in children)
    • Peritonsillar abscess (in children)
    • Pyloric stenosis or hypertrophic pyloric stenosis (in children)
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Foreign body ingestion
    • Paediatric gastrointestinal endoscopy
    Mais Diretrizes
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