Hard to Swallow Advice From Dr. Saad Saad

Dr. Saad Saad is a skilled pediatric surgeon who has forty years of experience removing foreign objects from the esophagus (food pipe) and the trachea (windpipe). During his career, Dr. Saad has helped over 1,000 children, aged as young as six months old to as old as fourteen years of age, get food and other objects stuck in the esophagus and trachea. We were able to interview him recently about his experiences in this specific area of expertise.


What Happens When Kids Swallow a Foreign Object?

Kids are curious enough to put a lot of things in their mouth and swallow them. This is especially true when it comes to young kids; there is a reason why “terrible twos” is a tough time to be a parent. Most of the time, the object will pass through the food pipe and into the stomach without serious complications, but sometimes an object can get stuck in the food pipe or accidentally go down the windpipe. Common signs of a stuck object include trouble breathing, trouble swallowing, and wheezing.

Peanuts, hot dogs, and coins—these are examples of common objects that can get stuck when a child swallows them. Larger objects like coins and hot dogs typically get stuck in the food pipe, while smaller objects like peanuts typically get stuck in the windpipe.

If a child is less than 6 years of age, to get an object unstuck you can turn them upside down and hold them by their legs. While holding them, tap on their back and most of the time the stuck object will pop right out. If the child is older, perform the Heimlich maneuver by standing behind the child, wrapping your hands around their waist, and thrusting your hands into their abdomen just below the rib cage. Again, most of the time the child will cough the object back out. But if these maneuvers don’t help, then the child should be taken to the emergency room.

If you see a child swallow an object, do not try to scoop it out with your finger. Trying to scoop it out can cause further blockage and push the object further down into the body of the child.

In the emergency room, an X-ray can help determine if an object is indeed stuck in the food pipe or the windpipe. Unfortunately, an X-ray can only detect about 50 percent of objects that get stuck; a coin, for example, can clearly be seen on an X-ray but not a peanut. If everything looks normal on the X-ray but the child still shows symptoms of a stuck object, then the next step is to perform a bronchoscopy or an esophagoscopy

Dr. Saad has personally performed many endoscopies and bronchoscopies during his career. In fact, he even invented an improvement for endoscopes to help him and other doctors better perform this procedure. Endoscopes are optical devices that are used to look inside the food pipe or the windpipe of the patient. These can be extremely helpful in giving a doctor a clear picture inside the patient’s body when neck, chest and abdomen   x rays  are not helpful. But our esophagus and trachea produce a lot of liquids which can cause trouble to visualize the foreign bodies by fogging up the lens and obstructing the doctor’s view.

Normally, a doctor would have to take out the endoscope and use a vacuum to suck away liquid blocking their view before proceeding with further examination. But Dr. Saad invented a way to convert the anti-fog port on the side of the endoscope into a suction and irrigation device port. This way, the doctor can suck away any liquid that is blocking their view without needing to take the endoscope out of the patient’s body, saving time and making this process more efficient.


Dangerous Objects and Dr. Saad’s Personal Expertise

With his 40 years of personal expertise, Dr. Saad described two objects to be particularly dangerous when swallowed by a child.

Batteries are the most dangerous out of all foreign bodies that stuck in the esophagus when swallowed by a child. Since they are relatively small, a child can pick them up and swallow them without much trouble. And remember that in addition to common AA or AAA batteries, you likely have the much-smaller—and much easier to swallow—circular batteries in watches, cameras, calculators, and other small electronics. When swallowed, a battery can leak the acid that is inside of it, causing serious burns and severe injuries to a child esophagus or stomach. This is why it is extremely important to keep a careful watch when a child is playing with electronic toys, TV remotes, cameras, or any other electronic device that runs on battery power.

Peanuts are also surprisingly dangerous objects to swallow, especially for a small child. Since peanuts are small, they are more likely to get stuck in the windpipe than the food pipe. When they do get stuck in the windpipe, the liquid that is in our lungs can make them soft and allow them to expand, causing further blockage. Dr. Saad also described that it is difficult for doctors to take a peanut out of the windpipe. Using tweezers to grab a hold of the peanut can easily fragment it and allow the crumbles to scatter further through the lungs.

As a result, Dr. Saad suggests parents follow a few golden rules to ensure that kids avoid getting foreign objects stuck in their food pipe or windpipe. First, don’t allow kids under two years old to have hot dogs. Hot dogs are the perfect size to completely block the food-pipe  if not chewed properly. Second, don’t allow kids under the age of seven to eat peanuts. Peanuts can be extremely dangerous when they get stuck in the windpipe. Third, watch kids carefully during playtime to ensure they do not put anything they shouldn’t in their mouth. This, of course, can be incredibly hard to do, but it is important to be aware of your child’s surroundings. Also, watch out for siblings trying to put something in their sister’s or brother’s mouth.


Dr. Saad Saad’s Personal Stories

Dr. Saad Saad shows a display of foreign objects
Dr. Saad Saad displays foreign objects.

In his office, Dr. Saad has a showcase of foreign objects he had removed during his career. The objects in the case include common things, like coins, as well as more personal objects, like a locket with a picture of a sibling inside. Because of the number of coins that children swallow, Dr. Saad has learned to differentiate how long a coin has been inside of a child simply based on its color. If the coin is shiny, it was swallowed only six to eight hours before being taken out. But if the coin is darker it has been inside for a day. And if it’s rusted, then it’s been inside for almost a month!

The biggest object Dr. Saad has removed from a child’s food pipe during his career is a toothbrush. A 14-year-old child came in to him with abdominal pain. The pain was concentrated high up, just below the chest, which is not typical of abdominal pain. Despite the fact that the child insisted she did not swallow anything, this led Dr. Saad to suspect that a foreign was stuck in the child’s body. Indeed, the X-rays proved Dr. Saad right and he was able to remove the toothbrush safely.

The sweetest story when it comes to a stuck object that Dr. Saad has removed comes from a 6-year-old girl. As happens with all young kids, one of the girl’s teeth was getting loose and was about to fall out. Sadly for the girl, as she was coughing, she managed to swallow the tooth and get it stuck in her windpipe. This meant that the Tooth Fairy would not be there for her because the tooth did not fall out properly! But the Tooth Fairy did count on Dr. Saad. Dr. Saad was able to safely remove the tooth from the girl’s windpipe and gave it to  her parents who gave it  to the  the Tooth Fairy who brought  back to the girl next right !

Removing a foreign object from inside the patient’s body can be difficult. It requires the right expertise, especially when it comes to removing objects from the windpipe or food-pipe. Dr. Saad has developed that expertise over his long career and has had great success helping children in the process.


Read more about Dr. Saad Saad: http://medicaldailytimes.com/medical-inventions/life-saving-medical-inventions-dr-saad-saad/3570/

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About the Author: BJ Hetherington

BJ is the lead editor of Meical Daily Times. Fluent in French and proficient in Spanish and Arabic, he focuses on diseases and conditions. BJ is a graduate of York University In Toronto. When BJ isn't busy writing his next piece, he can often be found running the streets of the GTA.

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