Clinical Features
• Special symptoms
– Depend upon whether the foreign body is of non-vegetable or of vegetable nature.
frequently. – They lack coordination of swallowing and
glottic closure.
Etiology
• Adults who are unable to protect the airway, are also at risk of aspiration due to decreased airway protective mechanisms.
– The angle of divergence from the tracheal axis is smaller on the right.
– Airflow through the right lung is greater than through the left.
– The carina is more likely to be located to the left of midline rather than to the right.
– They lack molars for proper grinding of food. – They tend to be running or playing at the time
of aspiration. – They tend to put objects in their mouth more
• In adults, vegetable matter, meat, and bones rank highest, followed by dental and medical appliances. Aspiration of teeth after trauma is observed occasionally.
• Foreign body aspiration can result a spectrum of changes, from minimal symptoms, to respiratory compromise, failure, and even death.
Etiology
• Foreign body aspiration is most common in children aged 6 months to 4 years.
Pathophysiology
• Aspirated foreign bodies most commonly are lodged in the right main stem and lower lobe.
• Peanuts are by far the most commonly aspirated material in children, followed by organic material such as sunflower seeds, pieces of vegetables, and hazelnuts.
• Asymptomatic phase - Subsequent lodging of the object with relaxation of reflexes that often results in a reduction or cessation of symptoms, lasting hours to weeks.
• Most foreign bodies lodged distal to the larynx and trachea in the right mainstem bronchus.
– The diameter of the right main bronchus is larger than the left.
– Cough and dyspnoea occur at the time of accident.
– Bloodstained expectoration is sometimes present.
Clinical Features
• General symptoms
– Cough with or without dysponea. – Expectoration. – Asthmatoid wheeze.
the ear at the patient's mouth.
Clinical Features
• Bronchial foreign bodies
– Three distinct stages of a foreign body accident:
• Initial phase - Choking and gasping, coughing, or airway obstruction at the time of aspiration
• Complications phase - Foreign body producing erosion or obstruction leading to pneumonia, atelectasis, or abscess.
Clinical Features
• Initial symptoms
– Mental retardation – Alcoholism – Psychoses – Neurologic disorders
• A drawing pin in the left • A peanut in the right
main bronchus
main bronchus
Anatomy
Clinical Features
• Tracheal foreign bodies
– An audible slap heard ah.
– Palpable slap with respirations. – Asthmatoid wheeze heard with