Accidentally swallowing an object is common, but a sharp object poses unique risks. While many swallowed items pass through the digestive system without incident, sharp objects can cause internal injury. The body’s internal pathways are not designed to safely accommodate pointed or edged materials, making swift action important to prevent serious complications.
Immediate Actions and Warning Signs
Upon realizing a sharp object has been swallowed, it is important to remain calm and seek immediate medical attention. Do not attempt to induce vomiting, as this can cause the sharp object to inflict further damage to the esophagus or throat on its way back up. Avoid eating or drinking anything, including trying to push the object down with food, as this might worsen the situation or cause the object to become more deeply lodged.
Several warning signs can indicate that a swallowed sharp object is causing a problem. Difficulty breathing, coughing, or wheezing could signal that the object is obstructing the airway or is lodged in the upper part of the esophagus. Severe pain in the chest or throat, excessive drooling or spitting, or an inability to swallow saliva are also concerning symptoms. The presence of blood in saliva or vomit, or gagging and persistent vomiting, also necessitate urgent medical evaluation.
How Sharp Objects Move Through the Body
The human digestive system is a complex pathway designed to process food, typically moving it from the mouth, down the esophagus, into the stomach, and through the intestines. Food travels from the mouth to the stomach via the esophagus, a muscular tube about 25 cm long, through a series of contractions called peristalsis. Once in the stomach, strong acids and muscular churning further break down food before it moves into the small intestine. The small intestine then leads to the large intestine, or colon, from which waste is eventually expelled.
While the digestive tract is generally robust, certain areas are more susceptible to injury from sharp objects. The narrowest parts of the esophagus, such as the cricopharyngeus muscle at the top and the lower esophageal sphincter near the stomach, are common sites where objects can become stuck. Objects that pass into the stomach might get caught in its curves or at the pylorus, the opening to the small intestine. Further along, the various bends and turns of the small and large intestines, particularly the ileocecal valve, can also snag foreign bodies.
The body’s natural mechanisms, like peristalsis, generally try to push objects through, but sharp edges can hinder this process or cause impaction. While most ingested foreign bodies pass spontaneously, approximately 10-20% require medical intervention. This means a notable number of cases will need professional help. Objects longer than 6 cm or wider than 2.5 cm are less likely to pass naturally through the intestinal tract.
Serious Concerns and Treatment
Swallowing a sharp object can lead to several serious complications within the digestive tract. One significant concern is perforation, which is the puncturing of a hole in the wall of the esophagus, stomach, or intestines. This can allow digestive contents to leak into the abdominal cavity, potentially leading to a severe infection called peritonitis. Internal bleeding can also occur if the object lacerates blood vessels along its path.
Obstruction is another potential complication, where the object completely blocks the passage of food and waste, causing severe abdominal pain, nausea, and vomiting. If the object remains lodged, it can lead to inflammation, tissue damage, or the formation of an abscess. These complications often require prompt medical intervention.
Medical professionals typically begin with diagnostic imaging, such as X-rays or CT scans, to locate the object and assess for any immediate damage. For objects found in the esophagus or stomach, an endoscopy is a common procedure for removal. During an upper endoscopy, a thin, flexible tube with a camera and instruments is inserted through the mouth to visualize and retrieve the object. If the object has moved further into the lower digestive tract or if complications like perforation or obstruction have occurred, surgical intervention may be necessary to safely remove the object and repair any damage.