Management of Glass Ingestion

Initial Evaluation and Management

Patients who have ingested glass should undergo immediate radiographic evaluation with neck, chest, and abdominal radiographs to determine the presence, location, shape, and size of the glass fragments, followed by appropriate management based on imaging findings and symptoms 1
The World Journal of Emergency Surgery recommends plain radiographs of neck, chest, and abdomen as first-line to locate glass fragments 1
CT scan is indicated if perforation is suspected or if complications require surgical intervention, as recommended by the World Journal of Emergency Surgery 1
Laboratory tests such as complete blood count (CBC), C-reactive protein (CRP), and blood gas analysis for base excess and lactate should be performed if perforation is suspected, as recommended by the World Journal of Emergency Surgery 1

Urgent endoscopic removal is recommended for large (>2 cm) or sharp glass fragments located in the esophagus or stomach, with endoscopy performed within 6 hours for sharp-pointed objects, as recommended by the World Journal of Emergency Surgery 1
Immediate endoscopic evaluation is recommended for patients with dysphagia, odynophagia, or pain, regardless of radiographic findings 1

Surgical intervention with primary repair is recommended for esophageal perforation if identified early, as recommended by the World Journal of Emergency Surgery 1
Minimally invasive techniques should be considered first-line in referral centers for esophageal perforation, as recommended by the World Journal of Emergency Surgery 1

Inducing vomiting is not recommended as it may cause additional trauma or perforation, as advised by the American Heart Association, published in Circulation 2
Administering anything by mouth is not recommended unless advised by poison control or emergency personnel, as advised by the American Heart Association, published in Circulation 2
Activated charcoal or ipecac should not be administered, as advised by the American Heart Association, published in Circulation 2
The Poison Help hotline (800-222-1222 in the US) should be contacted for additional guidance, as recommended by the American Heart Association, published in Circulation 2