FOREIGN BODY IN AIR PASSAGES

V Pujitha
roll no 141
CONTENTS
01 DEFINATION

02 ETIOLOGY

03 NATURE OF FB

04 CLINICAL FEATURES

05 DIAGNOSIS

06 MANAGEMENT
 Definition

• An object is considered a "foreign body" if the object is in a location in the body

where it does not belong.

Large fb lodges in supraglottic area

Small fb trachea or bronchi
Sharp fb can stick anywhere
Etiology

Children more affected (below 4 years)

Vegetable FB

- Peanut is a common vegetable FB

- Almond seed, peas, beans, wheat seed

Non-vegetable FB

- Whistle, plastic toys, safety pin, ball bearing

• In adults: Coma, deep sleep, alcohol intoxication (loose teeth or denture)

Nature of FB

Non irritating

- Plastic, glass, metal

- May remain symptomless for a long time

Irritating

- Vegetable FB

- Diffuse violent reaction (vegetal bronchitis)

- Swell up

Airway obstruction
 Clinical Features

Initial period
choking, gagging & wheezing Lasts for a short time May be coughed out or lodge further down

Symptomless period

- Respiratory mucosa adapts to FB

Later symptoms

- Depend on site of lodgment

 laryngeal symptoms

Sudden death (large FB)

- Pain in throat

- Change of voice

- Croupy cough

- Aphonia

- Dyspnoea

- Wheezing
 Tracheal Symptoms

Sharp FB: Cough & hemoptysis

• Loose FB: Auditory slap or Palpatory thud

• Wheeze may be present (heard with open mouth

 Bronchial Symptoms

Right FB Left FB

- Right bronchus is wider & more in line with trachea

Diagnosis

History of FB 'ingestion'

Classical triad

- Sudden onset of coughing

- Wheezing, and

- Decreased air entry on auscultation

X-Ray neck/chest PA and lateral view

- It shows size, shape & location of radio- opaque FB

- Atelectasis, emphysema, mediastinal shift

Fluoroscopy

• CT scan chest
 Management

Laryngeal FB

- Heimlich's maneuver

- Cricothyrotomy or emergency tracheostomy

Management

Tracheal and bronchial FB

- Rigid bronchoscopy

- Rigid bronchoscopy with telescopic aid

- Rigid bronchoscopy with C-arm fluoroscopy

- Dormia basket or Fogarty's catheter (round FB)

- Thoracotomy and bronchotomy

- Flexible fibreoptic bronchoscopy

 Reference

• Diseases of Ear, Nose & Throat (& Head and Neck

Surgery) By PL Dhingra & Shruti Dhingra
Thank you!