“Foreign objects are not a game”

Over the last weekend, a four year old boy from Pardes Hanna-Karkur was brought to the Hillel Yaffe Medical Center Pediatric Emergency Medicine Unit after swallowing a piece of plastic from the toy he was playing with. The part was in the form of a circle joined to around 5cm of metal wire. An X-ray showed the foreign object to be in the abdominal cavity. The speed of the staff’s response meant that the foreign object was speedily removed within one hour of the child's arrival at the Emergency Room. “In a situation like this, every minute is critical. There is a danger of the sharp part piercing the abdomen or the intestinal wall, if it would have moved on from the stomach,” explains Dr. Orly Eshach Adiv, Director of the Pediatric Gastroenterology Service at Hillel Yaffe, who removed the foreign object from the boy’s stomach. “It is not at all self-understood that in under an hour a team made up of two anesthetists, a nurse, and a gastrologist, could organize themselves with all the necessary equipment to remove the foreign object from the stomach. Particularly in this case which was more complex, where we had to use general anesthesia since the child had not been fasting, and then insert a tube into the trachea to remove the foreign object,” added Dr. Eshach Adiv. As noted, the foreign object was removed from his stomach and the child released home in good health.

The next day brought another case of a toddler aged a year and ten months who also arrived at the Pediatric Emergency Medicine Unit after his parents suspected he had swallowed a ten shekel coin. The parents related that the day before the baby had been playing with the coin and only the next day, after he vomited several times, his parents began to suspect he had perhaps swallowed the coin. An X-ray clearly showed the coin in the upper part of the esophagus. “After we found that the coin was stuck in the upper part of the esophagus, we quickly took the toddler into the operating room, and using a rigid endoscope – a special tube that contains a light source, we extracted the stuck coin under general anesthesia,” noted Dr. Itzhak Braverman – Director of the ENT – Otolaryngology, Head & Neck Surgery Unit, and Dr. Yitzchak Shochat, a resident in the unit. The two successfully removed the coin, and the little boy remained for observation for another day, after which he was sent home healthy. Dr. Braverman emphasizes that the most dangerous problem is when foreign objects are breathed into the lungs, that can cause shortness of breath in children and even asphyxiation.

The coin stuck in the toddler’s esophagus, as seen in the X-ray taken at the hospital

Dr. Eshach Adiv relates that, unfortunately, cases of swallowing foreign objects are regular occurrences, with the number of incidents rising during the summer vacation since children spend more time at home. She therefore calls on parents to make sure their children are not playing with small, sharp objects that can eventually cause irreversible damage. “There are objects that must be kept out of children’s reach, such as small magnets, button batteries, sharp objects, and absorbent polymers (plastic beads for decorating vases that swell up when exposed to liquids) that can cause total intestinal obstruction after being swallowed. It’s true that most small foreign objects are not sharp and are harmless, but parents need to keep their eyes open regarding particularly sharp objects.

“If there are respiratory symptoms or symptoms involving the digestive system, such as vomiting, difficulty swallowing, or drooling, an urgent trip should be made to the hospital for diagnosis and appropriate treatment,” concludes Dr. Eshach Adiv.