Foreign Body Aspiration
Foreign Body Aspiration in Children:
Children are naturally curious and often explore their environment by seeing, touching, and tasting objects. Unfortunately, this behavior can lead to foreign body aspiration, especially in younger children who lack molars to chew hard objects effectively. The small size of their airways also increases the risk.
Common Foreign Bodies Aspirated:
- Vegetable Foreign Bodies:
– Pieces of peanuts
– Betelnut (supari)
– Almonds (badam)
– Cashews (kaju) - Other Common Foreign Bodies:
– Small parts of toys
– Metallic objects: screws, nuts, etc.
Age Group Most Affected:
Common Age Range: The risk of foreign body aspiration is highest in children aged 6 months to 3 years. However, it can also occur in older children and adolescents.
Symptoms of Foreign Body Aspiration:
Common symptoms include:
- Coughing: Particularly after eating specific food items (e.g., peanuts).
- Choking: This can lead to breath-holding and turning blue (cyanosis).
- Difficulty Breathing: Unexplained respiratory distress.
- Wheezing: A whistling sound from the chest when breathing.
Physical Exam Findings:
- Doctors may notice differences in breath sounds on both sides of the lungs and wheezing during auscultation.
Diagnosis and Detection:
- Chest X-Ray:
– Some non-food items (like metallic objects) can be seen on a conventional X-ray.
– Most food items, vegetable matter, and plastic toys are not radio-opaque, meaning they may not appear on X-rays.
– Signs such as collapse or overinflation of lung segments may suggest the presence of a foreign body, but many cases may present with normal X-rays. - Flexible Bronchoscopy:
– The only definitive way to confirm the presence of a foreign body in the airway.
Imaging Studies:
- CT Scan/MRI of the Chest:
– Not useful for confirming foreign body presence in the airways due to difficulty in detection.
– Both CT and MRI may require sedation, and bronchoscopy would still be needed for confirmation.
Complications of Foreign Body Aspiration:
- Life-Threatening Risks:
– Large foreign bodies can block the larynx or trachea, leading to severe respiratory distress. - Smaller Foreign Bodies:
– Can lodge in the bronchi, leading to lung obstruction, infections, and long-term lung damage.
Treatment for Foreign Body Removal:
- Flexible Bronchoscopy:
– Typically performed under mild sedation in the bronchoscopy room.
– This procedure is preferred as it does not require general anesthesia. - Rigid Bronchoscopy:
– Occasionally necessary for sharp foreign bodies or long-standing objects.
– Involves general anesthesia, and a rigid bronchoscope is used to locate and remove the foreign body with specialized forceps.
