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Foreign Body – Causes, Symptoms and Treatment
A foreign body is any object or substance that enters the body unintentionally. Depending on its location and nature, it may require medical treatment.
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A foreign body is any object or substance that enters the body unintentionally. Depending on its location and nature, it may require medical treatment.
What Is a Foreign Body?
A foreign body is any object, material, or substance that does not naturally belong in the human body and has entered it either accidentally or intentionally. Foreign bodies can be found in various locations, including the skin, airways, digestive tract, eyes, ears, or deeper tissues. The severity of medical complications depends on the type, size, and location of the foreign body.
Causes and How They Occur
Foreign bodies can enter the body in several ways:
- Swallowing: Particularly common in young children – coins, toy parts, buttons, or food items such as fish bones can become lodged in the esophagus or gastrointestinal tract.
- Inhalation: Small objects or food pieces can be aspirated into the airways, especially the bronchi.
- Skin injuries: Splinters of wood, glass, metal, or thorns can penetrate deep into the skin or soft tissue.
- Eyes and ears: Insects, dust particles, small objects, or cotton fibers can enter the eyes or ears.
- Medical or surgical procedures: In rare cases, surgical instruments or materials may be unintentionally left inside the body.
Symptoms
Symptoms depend strongly on where the foreign body is located:
- Airways: Coughing, difficulty breathing, wheezing, or a feeling of choking – this is a medical emergency.
- Digestive tract: Difficulty swallowing, chest or abdominal pain, nausea, vomiting, or bleeding.
- Skin and tissue: Pain, redness, swelling, possible inflammation or signs of infection.
- Eyes: Foreign body sensation, tearing, redness, blurred vision, or pain.
- Ears: Pressure, pain, hearing loss, noises in the ear, or bleeding.
Diagnosis
Diagnosing a foreign body involves a combination of clinical examination and imaging techniques:
- Medical history and physical examination: The doctor asks about the incident and symptoms and examines the affected area.
- X-ray: Suitable for metallic or dense objects; wood or plastic may not be visible.
- Ultrasound: Useful for foreign bodies near soft tissue.
- Computed tomography (CT): Provides detailed imaging, especially valuable for deeply located or non-metallic foreign bodies.
- Endoscopy: Direct visualization of foreign bodies in the esophagus, stomach, intestine, or airways.
Treatment
Treatment depends on the type, location, and size of the foreign body, as well as the associated symptoms:
- Watchful waiting: Small, smooth foreign bodies in the gastrointestinal tract (e.g., swallowed coins) often pass through naturally without complications.
- Endoscopic removal: An endoscope can be used to gently remove foreign bodies from the esophagus, stomach, or bronchi.
- Surgical removal: Required for deeply lodged, dangerous, or inaccessible foreign bodies.
- Local anesthesia and tweezers: Superficial skin foreign bodies (e.g., splinters) can often be removed in an outpatient setting under local anesthesia.
- Irrigation: For foreign bodies in the eye, sterile eye irrigation may help.
Emergency Situations
Certain situations require immediate medical attention:
- Foreign body in the airway causing breathing difficulty or choking
- Swallowed sharp or corrosive objects (e.g., batteries, needles)
- Foreign body in the eye with severe pain or loss of vision
- Signs of infection or internal injury caused by a foreign body
In the event of airway obstruction in children or adults, emergency services should be called immediately and – where possible – the Heimlich maneuver should be performed.
References
- World Health Organization (WHO): Emergency triage assessment and treatment. www.who.int
- Marx J. et al.: Rosen's Emergency Medicine – Concepts and Clinical Practice. 9th edition. Elsevier, 2018.
- Byard R.W. et al.: Foreign body ingestion and aspiration in children and adults. Journal of Forensic Sciences, 2020. www.pubmed.ncbi.nlm.nih.gov
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