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Baby swallowed broken piece of glass

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  • Avatar kdeva 
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    My 11 month old daughter swallowed a broken piece of glass yesterday about 2cmx0.5 cm at 5:30 pm. She had something on her month, I asked her to open her mouth and I saw the glass but before I could reach down and pick her up she swallowed it. She gagged a little, so I tried putting my fingers in her mouth to search for it, but it was gone. There were a couple of drops of blood she spat out. I am sure it was glass because my son broke a glass this morning and I found a few more pieces after she swallowed the piece. I took her to the ER, they said that she was breathing well, so no chance of it in her breathing tube. She is able to breastfeed so they think the chance of the piece getting stuck in the esophagus is low.
    They took three x-rays, full body including abdomen, throat front and throat sideways and they couldn’t find anything. They sent us back home and asked us to observe her for signs of fever, blood in saliva or stool, feeding difficulty etc. So far, she is doing ok and breastfed well. She has a cough, but she is getting over a cold so I think the cough is just from the cold. I feel helpless and I don’t know what to do. I read a few papers that discussed retropharyngeal absessess and sepsis that happened to kids a week after injestion. I am worried sick, I don’t know what I can do to help her.

    #198394 Reply
    ENT Doc ENT Doc 
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    Was it hard plastic that may have been confused for glass? Glass should be radio-opaque on X-ray, especially something that big. 2cm is quite large. The lack of X-ray findings and concerning history/visualization are seemingly incongruous. She needs to be watched vigilantly. I could understand discharge since nothing was seen in x-ray but admission with close observation given the history and witnessed swallow isn’t unreasonable. Wishing her/you the best.

    #198398 Reply
    Liked by kdeva, SLC OB
    Zaphod Zaphod 
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    I’ve seen glass missed on xray before, especially if small. Also in OP said scary report xray missed the glass in that case as well. They suggested CT. Watch like a hawk for now, low threshold to return and demand fuller examination. Agree 2 cm is a giant piece of glass.

    After breaking and getting cut by glass days later  on several occasions and realizing glass pretty much “explodes” on contact, I sweep and then shop vac the whole area including crevices under counters and far from where you think it might be.

    Wishing you the best as well.

    #198408 Reply
    Liked by kdeva, Craigy
    Avatar kdeva 
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    It was definitely glass, I found a few more pieces in the corners after we got back home last night. What should I watch for? How long will I need to be very alert about her behavior?

    #198424 Reply
    Avatar Psyched 
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    Have you called your regular pediatrician for advice today?

     

    I don’t have much to offer except I am so sorry this happened and please update us! Having little kids is so scary and I have had my share of misses and accidents myself , we all do, so try not to beat yourself up over this.

     

    I am guessing that the breastmilk plus fact that she is probably eating some solids at 11 months will help “move things along” so to say, so that is a positive.

    #198433 Reply
    Liked by kdeva
    The White Coat Investor The White Coat Investor 
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    My 11 month old daughter swallowed a broken piece of glass yesterday about 2cmx0.5 cm at 5:30 pm. She had something on her month, I asked her to open her mouth and I saw the glass but before I could reach down and pick her up she swallowed it. She gagged a little, so I tried putting my fingers in her mouth to search for it, but it was gone. There were a couple of drops of blood she spat out. I am sure it was glass because my son broke a glass this morning and I found a few more pieces after she swallowed the piece. I took her to the ER, they said that she was breathing well, so no chance of it in her breathing tube. She is able to breastfeed so they think the chance of the piece getting stuck in the esophagus is low.
    They took three x-rays, full body including abdomen, throat front and throat sideways and they couldn’t find anything. They sent us back home and asked us to observe her for signs of fever, blood in saliva or stool, feeding difficulty etc. So far, she is doing ok and breastfed well. She has a cough, but she is getting over a cold so I think the cough is just from the cold. I feel helpless and I don’t know what to do. I read a few papers that discussed retropharyngeal absessess and sepsis that happened to kids a week after injestion. I am worried sick, I don’t know what I can do to help her.

    Click to expand…

    You’d be surprised what our GI systems can safely pass.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #198434 Reply
    The White Coat Investor The White Coat Investor 
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    Was it hard plastic that may have been confused for glass? Glass should be radio-opaque on X-ray, especially something that big. 2cm is quite large. The lack of X-ray findings and concerning history/visualization are seemingly incongruous. She needs to be watched vigilantly. I could understand discharge since nothing was seen in x-ray but admission with close observation given the history and witnessed swallow isn’t unreasonable. Wishing her/you the best.

    Click to expand…

    Yea, that is a little wacky. 2 cm is usually pretty easy to see on soft tissue x-rays, but I don’t know that I’ve x-rayed a lot of GI system glass. But even if it was visible, the plan would probably be serial x-rays. I mean, consider the alternative, at least once it leaves the duodenum.

    Guaranteed surgery versus possible surgery rather than an ex-lap to run the bowel trying to feel glass….

    I think I’d wait and watch carefully. Sure, watching in the hospital isn’t crazy, but at least one parent is a doc here. That seems like a trustworthy parent to return at the first sign of concern.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    #198435 Reply
    Liked by kdeva, Laeno
    jfoxcpacfp jfoxcpacfp 
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    Thinking about you, kdeva. Sorry I can’t offer any medical advice, just a fellow parent and a grandparent praying that my 7 grandchildren make it to adulthood in one piece. Hard to imagine what you are going through and hope this is soon behind you and a story to tease her about when she is grown.

    Probably best to turn off Google at this point. Babies get into so many things that should be really harmful but they are pretty resilient little creatures. You try to watch them every second but it’s just not possible, especially with other siblings to keep an eye on. Please let us know if you learn anything else and don’t be hard on yourself. You sound like a very responsible parent.

    Johanna Fox Turner, CPA, CFP, Fox Wealth Mgmt & Fox CPAs ~ 270-247-0555
    https://fox-cpas.com/for-doctors-only/

    #198438 Reply
    Liked by kdeva, Tim, adventure
    ENT Doc ENT Doc 
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    I would be sleeping with one eye open and wanting to look at those X-rays myself. 2cm is huge for a 11 month old. Again, should be seen on Xray.

    Fussiness, fever, vomiting, altered mental status, bloody stool – really just looking at me wrong would probably prompt me to go back with my child with the story and 100% confidence of glass you report.

    Time is sometimes the best answer. But the waiting sucks.

    #198440 Reply
    Avatar kdeva 
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    May be it wasn’t 2cm, more than 1cm for sure. It was a wide as her tongue, but narrow, like a cylinder. We are going to her pediatrician at 2 pm today. She had a little banana and some prune juice this morning. I am trying to give her food that will get her stool soft. I slept next to her last night and was checking on her all night, other than the cough she doesn’t seem bothered. She is her usual self and playing.

    #198445 Reply
    Liked by Tim, Zaphod
    Avatar kdeva 
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    Should I take her to a GI specialist or an ENT? Should I request a CT scan as a precaution?

    #198449 Reply
    ENT Doc ENT Doc 
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    See what the pediatrician recommends first. Maybe they can look at the images first?

    #198451 Reply
    Liked by kdeva
    Dreamgiver Dreamgiver 
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    I thought bananas dry up the stool (brat diet)

    #198452 Reply
    Avatar kdeva 
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    Saw her pediatrician. She is running a fever of 100.4 and has a cough and cold. But, the ped thinks the fever is because of the cough and she looks good otherwise. She wanted us to keep an eye on her and in case of spitting up/vomiting blood, blood in stool, abdominal distension, breathing difficulty, drooling a lot, increase in irritability, or fever over 103 and recommend if any of these symptoms occur we take the baby to the ER. Otherwise, followup with the ped tomorrow. Her ped thinks it could take up to a couple of weeks for symptoms to show, so asked me to continuously monitor her.

    #198507 Reply
    Avatar RollieStrummer 
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    A 1cm piece of glass is often not going to be visible on an x-ray.  If it is lodged in the neck, it may be seen on a soft tissue neck x-ray, but if it is in the esophagus, it’s probably not going to be visible on a chest x-ray, and is less likely to be visible on abdominal x-ray if it has passed into the stomach or small intestine.

    I’ve done hundreds of x-ray series for ingested foreign bodies, including dozens for glass specifically, and most of the time we don’t see glass, even if we know it is there.   Glass doesn’t block most of the the x-ray beams, so it doesn’t show up as a dense spot on an x-ray.  Since we don’t see the glass itself very well, what we are looking for is an interface between tissue and the glass.  If it is stuck in the esophagus, for example, on an x-ray taken from the front, superimposed on the area are the airways, the heart, the spine, etc, which makes it really hard to see.

    The glass may be seen with at CT scan, but that comes with a lot more radiation than an x-ray, and I’d avoid it in an 11 month old, unless there was a really compelling reason to do it.

     

    #198511 Reply

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