- Prevalence: Common accident in children, significant cause of morbidity and mortality. (infants and preschool)
- Statistics: 500 children die of FBA each year in the USA; 40% of lethal accidents among children under 1 year of age are caused by FBA.
Clinical Presentations
Acute Episode
- Period of choking, gagging, wheezing, hoarseness
Asymptomatic (Missed Diagnosis?)
- Cough, wheezing
Complications
- Pneumonia, obstructive emphysema, bronchiectasis
Diagnosis
- Medical history is key.
- Physical examination findings are abnormal in 80% of children with FBA and in 40% of children without FBs.
- Sensitivity and specificity of physical examination: 80.4% and 59%, respectively.
Radiological Examination
- Many FBs are not radiopaque, and small FBs may cause symptoms but not radiographic changes.
- Plain Film: Air trapping, obstructive emphysema, mediastinal shift
- Rt and Lt Lateral Decubitus Film
Common Aspirated Objects
- Food products (peanuts, seeds)
- Beans and seeds absorb water over time
- Inert FB (pieces of toys) cause less reaction
Negative Imaging Studies
- Do not exclude the presence of an FB.
- A high degree of clinical suspicion is crucial.
Removal
- Airway foreign bodies are removed most safely under general anesthesia using the ventilating rigid bronchoscope.
