Multiple Foreign bodies in the GI tract (11 of 12)

Healthy adults with ingested foreign bodies often give a
clear history of the inciting incident and may report a
foreign body sensation if the object is lodged in the upper
esophagus where somatic nerve endings are present. If a
meat bolus or other object is impacted in the lower
esophagus, they usually complain of more visceral-type
chest pain, odynophagia, and difficulty handling
secretions.
Objects that have passed into the stomach or beyond
frequently cause no symptoms, unless obstruction or
perforation has ensued.

Small children and adults with impaired mentation may not
give a clear history of foreign body ingestion. Clinicians
may have to rely on symptoms of obstruction, such as
drooling if the object is in the esophagus, or vomiting and
distention if it is impacted below the stomach. Patients may
also present with GI bleeding or signs and symptoms of
peritonitis owing to perforation. Small children often
display indirect symptoms such as gagging and choking,
refusal to eat, irritability, or respiratory distress if the
object is compressing the trachea or causing aspiration of
saliva. The possibility of foreign body ingestion should
always be considered in small children with new-onset
wheezing, especially if it does not respond to
bronchodilators.

Patients with rectal foreign bodies usually state clearly
that something is in the rectum, although they may be very
vague as to how it got there. These patients or their
partners have often made multiple attempts to remove the
object. Occasional patients may be unaware of the object if
intoxicated at the time of insertion, or may be too
embarrassed to admit to it, complaining instead of rectal
pain or bleeding. Patients with extraperitoneal rectal
perforation may present with sepsis, whereas those with
intraperitoneal perforation present with peritonitis.