No todos los cuerpos extraños son iguales en pediatría.

Abstract

Unintentional injuries related to foreign bodies (FB) are frequent in pediatric age. If any of these episodes are suspected, a correct anamnesis and a complete physical examination should be performed. Management will be individualized in each patient depending on the clinical context. If ingestion of FB is suspected, it is necessary to know its shape, size, number and composition, as well as the symptoms caused and the time elapsed since ingestion. An expectant attitude is recommended in asymptomatic patients, with FB less than 1 cm, not sharp, not elongated, not button batteries or magnets. If the FB does not meet these characteristics, an anteroposterior and lateral X-ray of the neck, chest and abdomen will be requested, in order to know its location and/or possible indirect signs of complications. In selected cases, endoscopy will be convenient and surgery will rarely be used. Aspiration of FB usually triggers a sudden episode of choking, severe coughing, and shortness of breath. It can be followed by an asymptomatic period that delays the diagnosis and favors infections and later respiratory problems. Chest X-ray is not always diagnostic, so bronchoscopy is useful as a diagnostic and therapeutic test in highly suspected cases. It is important to prevent this type of unintentional injury through knowledge of the most recurrent risk factors. The pediatrician must know how to recognize these episodes and act accordingly, as well as promote health education for parents and caregivers.