Clinical Experience of Removing Aerodigestive Tract Foreign Bodies With Rigid Endoscopy in Children

Abstract

Foreign bodies in the airway and esophagus constitute a constant hazard in all age groups, which demands immediate approach and management. Although the rigid endoscopic removal of aerodigestive foreign bodies was successful in this series, the most effective treatment of foreign body accidents is their prevention.

Tracheobronchial foreign bodies in infants

“…The relatively straighter anatomic alignment of the right main bronchus to the trachea and a wider lumen accounts for a preferential aspiration into the right main bronchus [29]. In one series, tracheal, laryngeal and bilateral bronchial foreign bodies have been separately noted in 17.3, 4.3 and 4.3%, respectively [26]. We found tracheal, laryngeal and bilateral foreign bodies in a similar proportion of infants.…”

“…The delay in presentation in infants aged 0-6 months may be due to lower level of parental awareness to the possibility of aspiration in this age group. The signs and symptoms in FBA are typically observed in three stages-an initial acute choking episode followed by violent coughing, gagging and complete airway obstruction; a second asymptomatic interval when the foreign body is impacted and respiratory reflexes are fatigued thus contributing to a delayed or missed diagnosis; and finally a third stage characterized by complications of a retained airway foreign body [26]. The clinical triad of coughing/choking, wheezing and unilateral decreased breath sounds was found to have a low sensitivity (26.5-42.6%) but high specificity (96.2-98.6%) in patients with FBA [17].…”

“…Nuts and seeds are commonly aspirated by children [7,24,26,29]. Peanuts were the commonest FB irrespective of age or the socioeconomic background of the child.…”

A clinical study on paediatric aero digestive foreign body in emergency department

“…The site of localisation in digestive and airway foreign body were similar to other studies, but difference in our study that there was equal incidence of the lodgement in the both bronchus, can be attributed to the fact that the angulation of the bronchus, occurs after the age of 7 years. [8][9][10][11] There was no complication in our study while doing oesophagoscopy/direct laryngoscopy/bronchoscopy, due to the reason that prompt removal of foreign body was done. All our patients were discharged by 3 rd postoperative day.…”

Endoscopic management of ingested foreign bodies in children: A retrospective review of cases, and review of the literature

“…Second, there is an asymptomatic interval after the reflexes become fatigued. The third stage is characterized by symptoms of complications [12]. Aspirated FBs should always be considered in children with unexplained recurrent pneumonia or other respiratory conditions that do not respond to appropriate treatment [13].…”