Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- disfagia
- dor abdominal inespecífica
- estridor e sibilância
- sialorreia
Other diagnostic factors
- engasgo, náuseas/vômitos, dor de garganta/pescoço
- dor torácica atípica ou dor torácica não cardíaca
- sufocamento
- hemorragia digestiva baixa
- dor ao deglutir
- febre, baixa aceitação alimentar, retardo do crescimento pôndero-estatural e irritabilidade (em crianças)
- sintomas agudos ou crônicos semelhantes aos da asma ou pneumonia recorrente
- sinais de sepse
- sinal de intoxicação aguda por drogas
Risk factors
- idade <15 anos
- sexo masculino (adultos)
- estenose do trato gastrointestinal
- dependência química
- deficiência intelectual
- transtorno mental
- detentos ou pessoas envolvidas em atividades criminosas
- transtornos dentários
- alimentação apressada
- reflexo faríngeo diminuído
- história de doença esofágica subjacente, cirurgia ou procedimento
- transtorno convulsivo
Diagnostic tests
1st tests to order
- radiografia cervical, torácica, abdominal
- Hemograma completo
- perfil metabólico básico
- tempo de protrombina (TP)/INR, TTP
- detector de metais portátil
Tests to consider
- biomarcadores cardíacos e ECG
- TC cervical, torácica e/ou abdominal
- RNM
- laringoscopia
- endoscopia
Treatment algorithm
pacientes instáveis
pacientes estáveis: corpo estranho orofaríngeo
pacientes estáveis: corpo estranho esofágico ou retal (exceto múltiplos ímãs e pilhas)
pacientes estáveis: corpo estranho esofágico ou retal – múltiplos ímãs
pacientes estáveis: corpo estranho esofágico ou retal – pilhas
pacientes estáveis: corpo estranho no estômago, intestino delgado proximal ou fora do alcance do endoscópio (excluindo múltiplos ímãs e baterias)
pacientes estáveis: corpo estranho no estômago, intestino delgado proximal ou fora do alcance do endoscópio, vários ímãs
pacientes estáveis: corpo estranho no estômago, intestino delgado proximal ou fora do alcance do endoscópio, baterias
Contributors
Authors
Brian M. Fung, MD
Gastroenterology Fellow
Division of Gastroenterology and Hepatology
Department of Internal Medicine
University of Arizona College of Medicine - Phoenix
Phoenix
AZ
Disclosures
BMF is the author of one reference cited in this topic.
Acknowledgements
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.
Disclosures
ACM, JCM, and LFL declare that they have no competing interests.
Peer reviewers
Prakash Adhikari, MBBS, MS
Consultant
Ganesh Man Singh Memorial Academy of ENT and Head and Neck Studies
TU Teaching Hospital
Maharajgunj
Kathmandu
Nepal
Disclosures
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
Disclosures
JFA declares that he has no competing interests.
Richard V. Schaller, Jr, MD
Clinical Research Fellow
Cleveland Clinic Florida
Weston
FL
Disclosures
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
Disclosures
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.
References
Key articles
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.Full text Abstract
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. Abstract
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. Abstract
Thabet MH, Basha WM, Askar S. Button battery foreign bodies in children: hazards, management, and recommendations. Biomed Res Int. 2013;2013:846091.Full text Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Epiglotite/supraglotite (em crianças)
- Abscesso peritonsilar (em crianças)
- Estenose pilórica ou estenose pilórica hipertrófica (em crianças)
More DifferentialsGuidelines
- Foreign body ingestion
- Paediatric gastrointestinal endoscopy
More Guidelines
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