TYK270

All of the following should undergo emergent foreign body retrieval EXCEPT:

a) A 3 year-old who was witnessed to ingest a button battery 45 minutes ago

b) A 10 year-old with cerebral palsy who has been coughing for the past 2 hours since lunchtime

c) A 9 month-old who was found with peanuts in his hand and is wheezing

d) A 2 year-old who swallowed a damaged tooth fragment and has a radiograph showing the tooth in the stomach

e) A 3 year-old with a dime lodged in the upper esophagus with no symptoms.

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Answer

Answer d. Each of these patients requires retrieval of foreign body for various reasons. Patient A is at risk of life-threatening erosion due to the button battery. Patients B and C have active symptoms of a foreign body in the airway (patient C may also be having an allergic reaction, but it is prudent to rule out foreign body in this case). Patient E has no symptoms but a high-risk of conversion from esophageal to airway foreign body without intervention. Patient D has ingested a non-damaging foreign body and it has already passed the lower esophageal sphincter; this usually does not require further intervention.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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