Small Objects, Deadly Emergencies For Children

Every week, the Department of Paediatric Surgery at AIIMS Delhi treats an average of two emergency cases of children who have swallowed foreign objects—from coins to dangerous button batteries, metal springs, earrings, toy parts, and magnets. Doctors warn that these incidents are common and can turn fatal if medical care is delayed.

“In one rare case, we treated a young girl who had swallowed a dangling earring she found lying on the bed,” said Professor Dr. Vishesh Jain from the Department of Paediatric Surgery at AIIMS Delhi. He emphasized that children, especially infants and toddlers, are at high risk because they explore their surroundings by putting objects into their mouths. “These objects can cause severe internal injury within a very short time,” he said, adding that children become especially vulnerable once they start moving around and exploring their surroundings, with cases seen up to 14 years of age.

Foreign objects can lodge either in the oesophagus (food pipe) or the windpipe, both of which can be life-threatening.

In a recent and particularly challenging case, a team led by Dr. Jain successfully saved the life of a 14-month-old girl who had swallowed a large metal spring. The spring, measuring nearly two inches in length and about half an inch in thickness, became lodged in the child’s oesophagus, also known as the food pipe, causing serious damage.

The child, a resident of Yamunanagar, was brought to AIIMS after suffering from continuous vomiting for almost a week. She had also refused food for two days, raising concern among caregivers. An X-ray examination revealed a thick metal spring stuck in the upper part of the oesophagus, along with significant swelling and ulceration of the lining.

“The spring was much larger and thicker than a typical pen spring,” Dr. Jain explained. “The swelling and injury to the oesophagus meant that even a small error during removal could have caused a perforation, which can be life-threatening in such young children.”

An attempt to remove the object had earlier been made at a private hospital in Dehradun. However, due to extensive injury and swelling, doctors decided that proceeding further would be risky and immediately referred the child to AIIMS. Using advanced endoscopic techniques in a fully equipped operating theatre, Dr. Jain and his team carefully rotated and extracted the spring without causing further damage. The child responded well to treatment and was started on oral feeding the very next day.

Doctors say this case underlines the seriousness of foreign body ingestion in children, which remains a frequent paediatric emergency. Among the most dangerous items are button batteries, which are commonly found in toys, remote controls, watches, and hearing aids.

“Button batteries are extremely hazardous,” Dr. Jain warned. “They begin generating heat and corrosive chemicals as soon as they come into contact with body tissue. If not removed within two hours, they can cause severe burns, perforation of the oesophagus, and can even be fatal.”

Even coins, the most commonly swallowed objects, are not without risk. If these get lodged in the oesophagus, it can damage the lining within hours.

Another growing concern is the increasing availability of magnet balls, which have become a popular play item among children. “Magnets are particularly dangerous,” Dr. Jain said. “If more than one magnet is swallowed, they can attract each other inside the body and cause extensive internal injury, including perforation and infection.” He strongly advised parents not to allow children access to such items.

Doctors caution parents to watch closely for warning signs such as sudden coughing, choking, unexplained vomiting, refusal to eat, excessive drooling, or breathing difficulty. “If swallowing is witnessed, or if a child suddenly develops these symptoms, parents must assume a foreign body and seek medical care immediately,” Dr. Jain stressed.

He also highlighted the need for preparedness at healthcare facilities. “Hospitals treating children must have 24×7 access to bronchoscopy and endoscopy services along with trained medical teams, to manage such emergencies without delay. At AIIMS Delhi we have ensured such facilities,” he said.

Food-related choking is another major risk in young children. Doctors advise that peanuts should never be given to children under five years of age, as they can easily block the airway. Other unsafe foods include popcorn, hard candies, whole grapes, cherries with pits, and large pieces of raw carrots or hot dogs, all of which should be cut into very small pieces.

Doctors strongly urge parents and caregivers to keep all small objects out of children’s reach, regularly check floors and play areas, and ensure constant supervision. Delaying treatment, attempting home remedies, or waiting for symptoms to subside can have fatal consequences. Prompt medical attention remains the most critical factor in saving a child’s life.