Who removes foreign bodies? A guide to medical specialists

According to the CDC, thousands of emergency room visits annually are due to foreign bodies. Understanding who removes foreign bodies is critical, as the appropriate medical professional or specialist depends heavily on the object's location, size, and the severity of the situation.

Quick Summary

The medical professional best equipped to remove a foreign body varies greatly depending on the object's location and the urgency of the situation. From emergency room physicians for critical cases to specialists like ENTs or gastroenterologists, the right expert can ensure safe and proper removal.

Key Points

• Emergency Care: Seek immediate medical attention at the emergency room for critical foreign body situations, such as choking or objects near vital organs.

• Specialist Referral: Depending on the foreign body's location, you may be referred to a specialist like an ENT for ear/nose issues or a gastroenterologist for swallowed objects.

• At-Home Limitations: While minor removals like surface splinters can be handled at home, never attempt to remove deep or sharp objects, as this can cause further injury.

• Button Battery Hazard: Ingesting a button battery is a medical emergency that requires immediate intervention from an ER physician due to the risk of chemical burns.

• Imaging for Diagnosis: For internal foreign bodies, doctors often use imaging like X-rays to accurately locate the object before attempting removal.

• Prevention is Key: Many foreign body incidents are preventable through careful supervision of children and using proper safety equipment in work environments.

Understanding Foreign Body Removal

Foreign body removal is a common medical procedure that can range from a simple, in-office task to a complex surgical intervention. A foreign body is any object that has entered the body from the outside and should not be there. This can include anything from a splinter to a coin, a piece of glass, or even an insect. The method of removal is determined by a few key factors, primarily the object's location, composition, and its potential to cause harm.

General Practitioner or Urgent Care

For many minor incidents, your first stop may be your primary care physician or a local urgent care clinic. These providers are well-equipped to handle routine and non-emergent foreign body removals, such as:

• Splinters embedded just under the skin
• Small pieces of glass or metal near the surface
• Insects or small objects in the outer ear canal that can be easily retrieved

It is always wise to consult with a medical professional rather than attempting to remove something at home, especially if the object is deep, jagged, or near a sensitive area like the eye. A quick evaluation can prevent potential infection or further injury.

Emergency Room Physicians

In situations where a foreign body poses an immediate threat, the emergency room is the only appropriate destination. You should go to the ER if the object is:

• Lodged in the throat or airway: Causing choking or difficulty breathing.
• Impaled: A large object that has penetrated the body.
• A battery: Especially a button or disc battery, which can cause severe, rapid chemical burns if ingested.
• Deeply embedded: Requiring specialized equipment or sedation for removal.
• In the eye: Potentially causing damage to the cornea.

ER doctors are trained to manage these high-stakes scenarios and have access to the necessary diagnostic tools, such as X-rays, to locate the object and determine the best course of action.

Ear, Nose, and Throat (ENT) Specialists

For foreign bodies lodged in the head and neck, an otolaryngologist, or ENT, is the specialist who removes foreign bodies. They have specific training and tools to manage delicate areas such as the ear canal, nasal passages, and throat. This includes:

• Objects in the ear, such as beads or insects.
• Small items stuck in the nose, common in children.
• Impacted food or small objects high in the esophagus.

Gastroenterologists

When a foreign body has been swallowed and passed into the gastrointestinal (GI) tract, a gastroenterologist is the specialist who performs the removal. They use an endoscope, a thin, flexible tube with a camera, to enter the body through the mouth or rectum. The endoscope allows them to see the object and use small tools, like forceps or nets, to retrieve it. This is typically done for objects that are sharp, large, or have become lodged in the esophagus, stomach, or intestines.

General and Specialized Surgeons

For more complex cases where endoscopic or external removal is not possible, a surgeon may be required. This could involve open surgery to retrieve an object that has perforated an organ, moved to a location inaccessible by other means, or caused significant internal damage. Depending on the location, this could be a general surgeon or a specialist, such as an orthopedic surgeon for an object in a joint or a vascular surgeon for a foreign body near a major blood vessel.

A Comparison of Foreign Body Removal Scenarios

Scenario	Common Location	First-Line Professional	Specialist When Needed
Minor Skin Injury	Hands, feet	General Practitioner, Urgent Care	Dermatologist
Object in Ear/Nose	Outer Ear, Nasal Cavity	General Practitioner, Urgent Care	ENT Specialist
Swallowed Object	Esophagus, Stomach	Emergency Room	Gastroenterologist
Large or Impaled Object	Anywhere on the body	Emergency Room	General Surgeon, Orthopedic Surgeon
Object in the Eye	On the surface of the eye	Emergency Room	Ophthalmologist
Object in Soft Tissue	Deep splinter, glass	Urgent Care, Emergency Room	General Surgeon

Preventing Future Incidents

While knowing who removes foreign bodies is important, prevention is key. Many incidents involving foreign bodies are preventable. For children, it involves closely supervising playtime, especially with small toys, and securing hazardous items like batteries. For adults, practicing safety in the workplace, such as wearing protective eyewear, can significantly reduce risks.

When to Seek Medical Help

Determining when to go to the doctor is crucial for a positive outcome. You should always seek professional help if:

1. The object is deeply embedded, sharp, or jagged.
2. There is significant pain, bleeding, or swelling.
3. The object is in a sensitive area like the eye.
4. The person is experiencing difficulty breathing or swallowing.
5. The object is a button battery, magnets, or a poisonous substance.

For more information on the management of ingested foreign bodies, particularly in a pediatric setting, you can consult guidelines from authoritative sources like the American Society for Gastrointestinal Endoscopy (https://www.asge.org/).

Conclusion

No single professional or facility is responsible for all foreign body removals. The right provider is chosen based on the specifics of the case. By knowing the signs of a serious problem and understanding the roles of different medical experts, you can ensure that you or your loved one receives the most appropriate and timely care, leading to a safer and faster recovery.

Frequently Asked Questions

Who removes foreign bodies from a child's ear or nose?

For children, a foreign body in the ear or nose is often handled by an emergency room physician or an Ear, Nose, and Throat (ENT) specialist, particularly if the object is difficult to reach or the child is uncooperative. Never attempt to remove it yourself, as you might push it in deeper.

What kind of doctor removes foreign bodies that have been swallowed?

A gastroenterologist is the specialist who typically removes foreign bodies that have been swallowed. They use an endoscope to enter the gastrointestinal tract and safely retrieve the object without surgery.

When should I go to the emergency room for foreign body removal?

You should go to the emergency room immediately if a foreign body causes a choking hazard, is a battery, is impaled in the body, or is causing significant pain, bleeding, or difficulty breathing.

Can an urgent care center remove a foreign body?

Yes, an urgent care center can typically handle minor foreign body removals, such as a surface splinter or a small, non-threatening object. They are not equipped for complex or life-threatening situations.

Who removes foreign bodies from the skin, like a deep splinter?

For a deep splinter or object embedded in the skin, a general practitioner or urgent care doctor can often perform the removal. If it's too deep or becomes infected, a surgeon might be consulted.

What is the difference between a gastroenterologist and an ENT specialist for foreign body removal?

An ENT specialist handles foreign bodies in the ear, nose, and throat (upper airway), while a gastroenterologist removes foreign bodies from the esophagus, stomach, and intestines (the GI tract).

Who performs surgery for foreign body removal?

A general surgeon or another surgical specialist will perform surgery to remove a foreign body. This is necessary when the object is inaccessible by other methods, has caused damage, or is lodged in a complex area.