Children inevitably swallow foreign material accidentally or intentionally. Each type of ingestion carries their own set of risks and complications, short and long term, some requiring immediate attention while others close monitoring. Alkalotic household cleaning products and lithium button batteries are increasingly common and damage the esophagus quickly. While many toys with rare-earth metals are banned, they are already present in many households and can cause necrosis of bowel that is between the magnets. This article reviews the incidence and assessment along with current literature to provide guidelines for management of pediatric patients with suspected caustic or foreign body ingestion.
Key points
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Caustic ingestions continue to cause significant morbidity in children, and review of proper household storage should be considered at well child visits.
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Major or fatal complications from button battery ingestions has significantly increased in the past 3 decades as they became increasingly commonplace in household devices, especially the 20-mm lithium button battery.
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Rare-earth metal magnets in toys were recalled, and production was banned by the Consumer Product Safety Commission in 2014. However, they are already present in many households and multiple magnets swallowed together can cause necrosis of any bowel that comes between the magnets.
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The introduction of laundry and dishwasher packets or “pods” has presented a new harm if ingested, causing respiratory distress, hospitalization, and possible intubation. These packets cannot be removed with an endoscope.
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