34. Foreign bodies in the bronchial system, foreign bodies of the oesophagus

From greek.doctor

Foreign body aspiration

  • Mostly in children < 3
  • 4x more often in the right main bronchus, due to its steeper incline
  • Peanuts, tablets, seeds
  • Clinical features
    • Coughing
    • Choking
    • Stridor
    • Dyspnoea
  • Complete obstruction – atelectasis
  • Partial obstruction – distal hyperinflation
  • Diagnosis
    • If severe obstruction -> clinical diagnosis
    • If non-severe obstruction
      • Chest X-ray
      • Bronchoscopy
  • Treatment
    • Heimlich
    • Removal with bronchoscopy



Foreign body in oesophagus

  • Foreign body in oesophagus is most common in children
  • In children: Coins, nuts, toys, button batteries, magnets
    • Button batteries are especially dangerous because they can short-circuit and perforate the oesophagus
  • In adults: Fish bones, dentures
  • Usually stuck in the hypopharynx or upper part of oesophagus
  • Clinical features
    • Pain
    • Feeling of pressure
    • Dysphagia
  • Diagnosis
    • X-ray
    • Oesophagoscopy
  • Treatment
    • Nothing (if asymptomatic, low-risk)
      • Try eating moist, wet bread or buns (eases passing)
      • Endoscopic removal if not passed within 24 hours
    • Urgent endoscopic removal (if high-risk)