FB Ingestion

Kid swallows FB 

SX

• Drooling, refusing to eat

• Esophageal perforation (bad) ➔ crepitus

• Mostly ASX when object makes it to intestine but can ➔ perforation or obstruction 

DX

• Flat coin (en face) on PA/AP chest X-ray means it is in esophagus

  • TX: Observation - Unless swallowed battery, magnets, or sharp object (emergent endoscopy)

• Side of coin (sagittal) on PA/AP chest X-ray means coin is in trachea

  • TX: Rigid bronchoscopy > flexible

Bezoar 

• Accumulation of ingested material

  • Phytobezoar  (MC) - vegetables - don't absorb barium

  • Trichobezoars - hair (trichotillomania with trichophagia) - absorbs barium

  • Pharmacobezoars - medications

• Usually incidental finding but can ➔  perf, pancreatitis, constipation, intussusception

DX 

• EGD

TX

• Chemical dissolution with Coca-Cola, endoscopic removal if Coke fails and sx

• Surgical removal if complications