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Foreign body

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Airway foreign bocy

  • Leading cause of death <1 yr
  • Male: female 2:1
  • Morbidity increases with delay in treatment
  • Peanuts most common
  • Balloons account for 30% of all fatal aspirations
  • Non food items (pens, paper clips, pins) more common in older children
  • Dried beans particularly dangerous because of tendency to swell in the airway
  • Delay in diagnosis common (54%)

Clinical features

Common

  • choking
  • history of choking episode most important feature highly suggestive of airway foreign body
    • failure to take adequate history and failure to act can be disastrous
  • coughing, gagging

Less frequent

  • fever
  • pneumonia
  • stridor
  • laryngospasm
    • may result in immediate death

Treatment

  • Avoid causing distress to child as this may dislodge foreign body from bronchus into trachea, causing complete airway obstruction
  • Rigid endoscopic removal successful in 98%
    • experienced anaesthetist and surgeon
  • Flexible endoscopy potentially dangerous and unlikely to be successful

Complications

  • bronchiectasis
  • pneumonia
  • lung abscess
  • airway obstruction causing chronic wheezing
  • death

 

 

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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