Immediate Questions

A. Is there a history of gagging, drooling, vomiting, sore throat, or dysphagia? Many of these symptoms indicate the presence of a foreign body in the GI tract.

B. Is patient refusing food? All of these symptoms could point to an esophageal foreign body.

C. Is there a history of midepigastric or chest pain? Lodging of a foreign body in the esophagus can lead to abdominal and chest pain.

D. Does patient have shortness of breath, coughing, or wheezing? If the object is compressing the trachea, these respiratory symptoms would be expected.

E. Were symptoms sudden in onset? The timing can be helpful in identifying a discrete event.

F. Is fever associated with the pain? These symptoms may indicate perforation, which is a very rare complication of foreign body ingestion.

G. Was the foreign body ingestion witnessed? Some patients with known foreign body ingestion are asymptomatic. In 30-40% of cases, patients with esophageal foreign bodies present without symptoms.

What is the foreign body? Common foreign bodies in children are coins, bones, pins, pencils, crayons, batteries, buttons, marbles, and paper clips. Food impactions occur most often with meat. Coins account for the majority of esophageal foreign bodies.

Does patient have a history of GI dysmotility? Dysmotility disorder can mimic or be caused by foreign body ingestions. Is there a history of esophageal strictures? Strictures could be due to a caustic ingestion or follow repair of esophageal atresia or tracheoesophageal fistula.

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