What should I do if I have swallowed a staple?

Management of Swallowed Staple

If you have swallowed a staple, most cases can be managed conservatively with observation as the foreign body will likely pass naturally through the digestive system without complications. 1

Initial Assessment

• Confirm what was swallowed and when it occurred

• Assess for symptoms:

  • Throat pain, difficulty swallowing, drooling
  • Chest pain, respiratory distress (rare but urgent)
  • Abdominal pain, vomiting, or signs of obstruction

• Consider obtaining plain radiographs (X-rays) of the neck, chest, and abdomen to:

  • Confirm the presence of the staple
  • Determine its location
  • Assess its size and orientation 1

Management Algorithm

Asymptomatic Patients

1. If no symptoms and staple has likely passed the esophagus:

   • Conservative management with observation at home
   • Monitor stools for passage of the staple
   • No dietary restrictions necessary
   • No need for activated charcoal (contraindicated for foreign body ingestion) 1

2. Follow-up considerations:

   • Most staples will pass through the digestive tract within 3-5 days
   • If uncertain about passage, a follow-up X-ray may be considered

Symptomatic Patients

1. If symptoms of esophageal impaction (difficulty swallowing, throat pain, drooling):

   • Seek immediate medical attention
   • Endoscopic removal may be necessary, especially if the staple is lodged in the esophagus 1

2. If symptoms of intestinal obstruction or perforation (severe abdominal pain, vomiting):

   • Seek emergency medical care
   • Surgical intervention may be required for complications such as perforation, severe hemorrhage, or persistent complete bowel obstruction 2

Special Considerations

• Sharp objects like staples: While most small, smooth objects pass without incident, sharp objects like staples have a slightly higher risk of causing complications, though still low overall

• Location matters: Objects in the esophagus require more urgent attention than those that have passed into the stomach or beyond

• Size consideration: Standard office staples are usually small enough (typically <2 cm) to pass through the digestive tract without complications

When to Seek Immediate Medical Attention

• Development of severe throat pain, difficulty swallowing, or drooling
• Chest pain, respiratory distress, or coughing
• Severe abdominal pain, vomiting, or signs of gastrointestinal bleeding
• Fever developing after ingestion

Common Pitfalls to Avoid

• Don't induce vomiting - This increases risk of aspiration and esophageal damage
• Don't administer activated charcoal - Not effective for foreign bodies and may complicate subsequent endoscopy if needed 1
• Don't assume all foreign bodies require endoscopic removal - Most small objects like staples will pass naturally

Most staples are small, smooth metallic objects that typically pass through the digestive tract without complications. The conservative approach with observation is appropriate for most cases, with intervention reserved for those with symptoms or complications.