Foreign bodies seem to have an amazing attraction for children, and it is incredible the number and range of items that are swallowed. The incidence is highest in infants in the 1-3 year age group. Coins, screws, nails, washers, bits from toys, plastic gadgets such as doll’s eyes, wheels from toy cars, and pins, safety pins and otherwise, have all gone down the red lane. Sheer good luck, and the body’s ability to deal with these onslaughts, make the risks happily fairly small.

Most foreign bodies simply pass through the full length of the bowel, and in the majority of cases are passed at the far end with little discomfort within four to five days. In fact, a parent may be totally unaware of what has occurred. Occasionally symptoms may develop, but overall this is uncommon. Usually, the doctor’s assistance is needed if there is pain, a fever or vomiting resulting from the incident.

Sometimes a foreign body may be held up at certain critical points in the bowel. A sharp object, such as a pin or a needle, may penetrate the bowel lining and fail to move or it may actually perforate the wall.

Treatment

Most cases do not require any treatment. However, if the foreign body is known and especially if it is a sharp, potentially dangerous one, treatment may become necessary. If symptoms (as noted) occur, it will require medical attention.

The doctor may ask for a bowel X-ray if the foreign body has not been passed within a few days. However, only about 2-4 per cent of cases require active surgical intervention. These days, with the use of a long, flexible device called the endoscope, it is possible to locate foreign bodies and remove them fairly simply under an anaesthetic.

There is probably one major exception to the suggestion of waiting for the child to pass the object. That is in the case of the miniature mercury batteries that are now widely used in hearing aids, cameras and calculators; it is becoming more common for these to be in homes, often in ready access to infants. Their shiny silver metal coat is attractive to some children, who suck them, and several cases of their being swallowed have been reported. The incidence will inevitably increase over the next few years.

The acid of the child’s stomach may rapidly destroy the thin metal lining of the battery, so releasing very toxic quantities of mercury which may be lethal to small children. If this occurs, immediate treatment either from the doctor or at the emergency ward of the nearest big hospital is essential. The battery must be removed as urgently as possible before it disintegrates and allows the toxic substances to be absorbed by the body. Never forget this danger.

Do not give cathartics for foreign bodies. Do not give cottonwool sandwiches or follow other antiquated old wives’ tales. These all belong to a bygone era. Castor oil is definitely out, and so is cascara and similar products. They could stimulate the bowel violently and with sharp objects increase the risk of perforation. Do not get hysterical—death is not imminent. Ring the doctor for advice or take the child immediately to the nearest large hospital.

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