Q&A What if he swallows it?

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What should I do if I suspect my 2-yearold has swallowed a coin? This happened to a friend on holiday. Should I take the child to hospital for X-rays?

If the coin is spotted, would they do surgery to remove it? Or do you just monitor the child’s poo for a few days to see if it comes out? Could a coin get stuck in the ystem forever?

DR COMBRINK ANSWERS: The highest incidence of foreign object ingestion occurs in children between the ages of 6 months and 3 years and children with developmental or behavioural problems. The majority of ingested foreign objects are low risk items and can be managed without the need for X-rays or surgical treatment. Gastrointestinal tract obstruction by a foreign object depends on the physical properties of the object, including its size, shape and composition.

HIGH-RISK FOREIGN OBJECTS INCLUDE

• Button batteries lodged in the oesophagus need immediate removal. However, once they enter the stomach, they are less concerning.

• Large objects – objects more than 6cm long and/or 2cm wide may become entrapped at the pyloric valve of the stomach. Super-absorbent polymers may also cause obstruction.

• Magnet or magnet and a metal object ingestion can cause serious and potentially life-threatening complications.

• Lead-based objects that fail to transit through the stomach may cause acute systemic lead absorption. Multi-component objects may break apart and progress separately in the gastrointestinal tract (for example, toys with lights and batteries) and may require removal.

It is rare for sharp objects to penetrate the mucosal wall of the gastrointestinal tract, and these require no intervention if the child is otherwise well.

Please take your child to the nearest emergency department if they show any of the following symptoms:

• coughing

• drooling

• pain when swallowing

• refusing to eat or drink

• abdominal pain or vomiting

• vomiting blood or passing blood in stool If there is evidence of coughing, choking or respiratory distress seek medical help immediately.

X-rays are not necessary in an asymptomatic child. However, imaging is required in suspected or known button, battery, magnet or unknown object ingestion or in a high-risk or unwell child. Further examination of the faeces is not recommended. Repeat X-rays are not necessary. ●