Swallowing a foreign object, such as a key, is a common accident, particularly among young children who explore the world by putting items in their mouths. While the scenario may cause immediate panic, most small, smooth foreign bodies pass through the digestive tract without causing any lasting damage. The ultimate outcome depends on the object’s size, shape, and whether it lodges in a narrow passage of the gastrointestinal system.
Immediate Triage and First Steps
The primary and most urgent concern immediately after a key is swallowed is airway obstruction, which is a medical emergency. If the person is choking, struggling to breathe, unable to talk, or showing signs of distress like drooling or a high-pitched sound when inhaling, emergency medical services (911) must be called immediately.
If the person is breathing normally, talking, and does not show signs of acute distress, the immediate danger has likely passed, and the object has moved into the stomach. Contact a medical professional or poison control center right away for advice. They will determine the next steps, which may involve a visit to the emergency department for imaging, especially if the object has sharp edges or is unusually large. Never attempt to induce vomiting, as this can cause a sharp object to become lodged in the esophagus on its way back up, potentially causing further injury.
How the Key Travels Through the Digestive System
Once a small, blunt object like a typical house key successfully passes the esophagus, it enters the stomach, where it is unlikely to be broken down by stomach acid. The key’s passage is then governed by the body’s natural muscular contractions, a process called peristalsis, which moves contents through the gastrointestinal tract. The object will typically pass from the stomach into the small intestine, a journey that can take a few hours.
The key will spend several hours traveling through the small intestine before moving into the large intestine. For most small foreign bodies, the entire transit time, from ingestion to excretion in the stool, generally takes between four to seven days. During this monitoring period, a doctor may advise inspecting the stool to confirm the object has passed safely. Increasing the intake of fiber-rich foods, or “roughage,” may be suggested to help cushion the key and facilitate its movement.
Identifying and Treating Serious Complications
While most swallowed foreign bodies pass, sustained symptoms can indicate the key is lodged or has caused internal injury. Signs of a serious complication include persistent vomiting, blood in the vomit or stool, severe or worsening abdominal pain, or a fever. These symptoms can point toward an obstruction, where the key is blocking the digestive tract, or a perforation, where a sharp edge has punctured the lining of the stomach or intestine.
If the key does not pass within the expected timeframe or if concerning symptoms arise, medical imaging, such as X-rays, will be used to locate the object. If the key is stuck in the esophagus or the stomach, the primary intervention is an endoscopy. This procedure involves inserting a thin, flexible tube with a camera and tools through the mouth to visualize and retrieve the object. Surgical removal is reserved for less than one percent of cases, typically when the object has caused a perforation or is lodged in an area of the small intestine unreachable by an endoscope.