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Pediatrics
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Suspected Foreign Body Ingestion
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X-rays first; endoscopy for high-risk objects.
Decision
Outcome
Decision
Suspected foreign body ingestion. First imaging?
✓
PA + lateral X-rays (CT if not visible on X-ray)
Decision
High-risk features (respiratory/obstructive symptoms, button battery, magnet, sharp item)?
✓
Yes → endoscopic removal
✓
No → serial X-rays
Outcome
Endoscopic removal — button battery in esophagus is emergency (caustic injury within hours)
Button battery in stomach: remove if symptomatic or >2 cm (or coingestion with magnet).
Decision
Object transit?
✓
Moving distally → no intervention
✓
No transit → endoscopic removal
Outcome
Observe with serial imaging; expect passage within days to a week