Foreign body ingestion

Another ED special lol

History What objects? How many?
Safeguarding → supervision?
Examination A: airway obstruction → Impending airway doom
B: wheezing? (see Foreign body in ENT)
C/D...
E: dysphagia, drooling, refusing food, globus sensation
Investigations Neck/chest/abdo XR in 2 views

magnets

Main hazard: multiple strong magnets being attracted to each other between loops of bowel → perforation/ischaemia
Key history What kind of magnets? Ceramic vs rare earth (neodynium) - rare earth magnets are 5-10x stronger
Diagnostic investigations AP and lateral CXR + AXR
Immediate management Risk - perforation with multiple magnets
If definite evidence of single magnet, may be safe for discharge
Ongoing management Endoscopic vs laparotomy for removal

EOE ODN guidelines