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Guidance for the assessment and management of ingested foreign bodies, including a management algorithm.
Children that have ingested a foreign body.
Medical and nursing staff in the Emergency Department.
*** IF SUSPECTED OR KNOWN INGESTION OF BUTTON BATTERY THEN DISCUSS WITH ED SENIOR IMMEDIATELY ***
History of foreign body ingestion is a common presenting complaint. Metallic foreign bodies are more commonly implicated than non-metallic. Coins are the most common.
Most ingested foreign bodies will pass harmlessly through the GI tract. However oesophageal impaction is a recognised complication even in the asymptomatic  with potentially serious sequelae such as oesophageal perforation, mediastinitis and ulceration.
Metal detectors have been used to detect metal foreign bodies in several studies. They have been proven to be both sensitive and specific in confirming presence of coins in particular, and localising them to above or below the diaphragm .
1. Litovitz T & Schmitz BF. (1992) Ingestion of cylindrical and button batteries: an analysis of 2382 cases. Pediatrics 89, pp. 747–757. [NOTE: contact firstname.lastname@example.org quoting your Athens username to receive the publisher password for this journal]
2. Lee JB, Ahmad S, & C P Gale CP. (2005). Detection of coins ingested by children using a handheld metal detector: a systematic review. Emerg. Med. J. 22: 839 - 844.
3. Choudhery V & Maurice S. (2000) BEST EVIDENCE TOPIC REPORTS: Signs and symptoms of oesophageal coins. Emerg. Med. J., Mar 2000; 17: 126 – 127.
Last reviewed: 24 February 2017
Next review: 13 November 2019
Author(s): Steve Foster
Approved By: Clinical Effectiveness