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Foreign Body Aspiration
Aspiration Foreign Body

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WIKIDATA, CC BY-SA 3.0
WIKIDATA, CC BY 3.0

Presentation

No correlations between event symptoms, hospital presentation, radiographs and foreign body presence. CONCLUSION: Event history, hospital presentation, and radiographs are insufficient in proving the absence of a radiolucent foreign body. [ncbi.nlm.nih.gov]

Average hospital stay was 2 days (1-3 days) in early presentation group and 4 days (2-7 days) in late presentation group. [afrjpaedsurg.org]

Entire Body System

  • Foreign Body Aspiration

    A total of 27% of children with foreign body aspiration and 33% of children without a foreign body had suggestive decubitus radiographs (P = not significant). [insights.ovid.com]

    Foreign body aspiration Chest x-ray of a child after aspiration of a peanut: hyper-inflated left lung due to a valve mechanism of the peanut in the bronchus Specialty Respirology Foreign body aspiration occurs when a foreign body enters the airways and [en.wikipedia.org]

    Location incidence of aspirated foreign bodies in children. [emra.org]

    Keywords: Balloon, Cyanosis, Foreign body aspiration, Respiratory distress Introduction Foreign body aspiration with subsequent airway obstruction typically occurs in children between the ages of six months and five years. [ncbi.nlm.nih.gov]

  • Fever

    A 13-year-old male presented with a three-weeks' history of a cough and swinging fevers. Subsequent investigation revealed a foreign body causing collapse of the right middle and lower lobe with abscess formation. [ncbi.nlm.nih.gov]

    Patients may present with a history of fever, breathlessness, or wheezing or with features of a nonresolving pneumonia. [patientcareonline.com]

  • Pain

    Management Frontiers in Medicine Epidemics Zika Virus Ebola Virus View all topics Health Policy Epidemics Pain Management Ebola Virus Multimedia Multimedia Selected Multimedia View all multimedia Audio Clinical Practice Audio Interviews Interactive Medical [nejm.org]

    The clinical presentation was cough, sputum and chest pain which was relieved almost instantly after aspiration. [aclr.com.es]

    […] body location Anterior jaw pain (pharynx) Neck Pain (cervical esophagus below cricopharyngeous) Chest Pain (thoracic esophagus) Initial Associated Symptoms or signs (may be asymptomatic) Cough Wheezing or Stridor Choking Dysphagia Dysphonia Chronic Symptoms [fpnotebook.com]

    We are reporting on a case of a fiftythree- year old women with recurrent, non-resolving pneumonia, recurrent hemoptysis, dyspnea, fiver, chest pain and radiological presentation of middle lobe neoplasm caused by aspirated chicken neck bone. [ncbi.nlm.nih.gov]

  • Inflammation

    The attempt of foreign body removal was failed due to chronic inflammation, and the patient refused further surgical management. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. [ncbi.nlm.nih.gov]

    Serial fiberoptic bronchoscopy documented a gradual resolution of the granulation tissue and inflammation. (Korean J Med 77:S1178-S1182, 2009) Keywords: Actinomycosis ; Foreign bodies ; Bronchoscopy [ekjm.org]

    Significant local inflammation usually starts 2 – 3 days after aspiration. Symptoms: Coughing, wheezing, suprasternal retractions. Respiratory distress, cyanosis. [kidsdoc.at]

    If partial obstruction of the airway results, a subacute process may result in infection, inflammation, and lung injury distal to the lodged object. [accesspediatrics.mhmedical.com]

    However, the longer the foreign body remains in the airways, the more likely inflammation and thus, complications will occur. [hawaii.edu]

  • Anemia

    A complete blood count (CBC) may be helpful in looking for potential infection (an elevated white blood cell count), anemia (a low hemoglobin), and indirectly, liver function (low platelet count). [emedicinehealth.com]

    Spectrum of anemia associated with chronic liver disease. World J Gastroenterol. 2009 Oct 7. 15(37):4653-8. [Medline]. [Full Text]. Braat MN, de Jong HW, Seinstra BA, Scholten MV, van den Bosch MA, Lam MG. [medscape.com]

Respiratoric

  • Aspiration

    aspiration can be tolerated and remain undetected for a long time. [ncbi.nlm.nih.gov]

    Location incidence of aspirated foreign bodies in children. [emra.org]

    A total of 27% of children with foreign body aspiration and 33% of children without a foreign body had suggestive decubitus radiographs (P = not significant). [insights.ovid.com]

  • Cough

    If an FBA remains undetected, it may result in chronic cough and recurrent pulmonary infections. Epidemiology References:[1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

    Patients often have an episode of choking and prolonged coughing, but symptoms may cease as the cough reflex is exhausted and/or the object lodges in a bronchus Other signs and symptoms Dyspnea Neck or throat pain Stridor and hoarseness may occur if object [pedclerk.bsd.uchicago.edu]

    The most frequent findings in history and physical examination were paroxysmal cough (81%), chocking (42%), chronic cough (42%),and respiratory distress (18%). [erj.ersjournals.com]

    KEYWORDS: airway obstruction; blowgun dart; cough; foreign body aspiration [ncbi.nlm.nih.gov]

  • Dyspnea

    The degree of dyspnea should be evaluated immediately, and patients in different dyspnea should be treated accordingly. For patients in Grade I dyspnea, simple bronchoscopic FBs removals could promise a good outcome. [ncbi.nlm.nih.gov]

    FBA typically manifests with sudden onset of coughing and choking, followed by stridor and dyspnea. Obstruction of the larynx or trachea is a potentially life-threatening situation that causes severe respiratory distress, cyanosis, and suffocation. [amboss.com]

    The patient was installing lights in his bakery, when he began to experience symptoms of dyspnea, so he took his inhaler (that did not have the mouthpiece cover in place) from his pocket, and used it. [archbronconeumol.org]

    Inspiratory and expiratory wheezing, hemoptysis, and dyspnea may also be observed in these patients [1–3, 8]. [hindawi.com]

  • Paroxysmal Cough

    The major complaints were paroxysmal cough and respiratory insufficiency. Foreign body aspiration was confirmed in 123 patients (65%). Of 106 patients who were admitted in the first 24 hours, FBA was confirmed in 75 patients. [ncbi.nlm.nih.gov]

    The most frequent findings in history and physical examination were paroxysmal cough (81%), chocking (42%), chronic cough (42%),and respiratory distress (18%). [erj.ersjournals.com]

    Common clinical features included choking (90%), paroxysmal cough and fast breathing followed by stridor and decreased air entry. [indianpediatrics.net]

    Between 50% and 90% of children have a suggestive history, most commonly of an acute episode of paroxysmal cough. Other common signs are cyanosis, choking, and dyspnea. [dontforgetthebubbles.com]

  • Acute Cough

    However, sudden onset of cough, choking, and/or dyspnea have been found to be the most common symptoms. One prospective study has cited a sensitivity of 91.1% and specificity of 45.2% for choking and acute cough. [ncbi.nlm.nih.gov]

Gastrointestinal

  • Choking

    Another mechanism of choking involves the impaction of foreign material in the esophagus with resultant airway compression. Choking results from a complex interaction between the victim, the environment, and the object at hand. [accesspediatrics.mhmedical.com]

    choking (symptom), choke, CHOKING, Choking (finding), Choking (finding) [Ambiguous], Choking Czech Dušení, dušení se Hungarian Fuldoklás Norwegian Kveling Dutch verstikking, Stikken Ontology: Foreign body in pharynx (C0161010) Concepts Injury or Poisoning [fpnotebook.com]

    For information about what to do if a baby is choking, see this resource on first aid for a baby who is choking. [ada.com]

    Keep potential choking hazards (such as small spherical objects and balloons) out of reach of children. Older siblings should be advised not to give potentially dangerous objects to younger children. [pedclerk.bsd.uchicago.edu]

    It also specifies that toy parts that are directly bound to the food must have a size such that they do not pose a choking hazard. [analesdepediatria.org]

  • Gagging

    RESULTS: Penetration syndrome (sudden onset coughing, choking and gagging) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. [ncbi.nlm.nih.gov]

    Presentation Lecture Pearls Diagnosis Treatment Patient will present as → a 2-year-old male child who is brought to the emergency department by his mother with a sudden onset of choking, gagging, coughing, and wheezing. [smartypance.com]

    His mother is unsure if he had eaten anything else with the potato chips and does not think the child turned blue during the choking and gagging episode. [hawaii.edu]

  • Nausea

    Ascites is very uncomfortable and causes nausea, tiredness, breathlessness, and a feeling of being full. Liver disease is the most common cause of ascites. Other causes typically include cancer and heart failure. [medicalnewstoday.com]

    Dyspnoea, chest pain, wheezing, fever, nausea or vomiting may follow this. Lemberg et al ( 3 ) reported the following symptoms Figure 3 Physical examination may show no abnormalities in large proportion of these cases. [ispub.com]

    He denied any fever, chills, headaches, hemoptysis, nausea, vomiting, recent sick contacts, significant travel history, or exposure to allergens. [hindawi.com]

    Smaller quantities of fluid are usually not noticeable; however, larger quantities cause the abdomen to distend, creating a painful feeling of pressure or a feeling of nausea. Very large quantities of fluid can also obstruct breathing. [pfmmedical.com]

  • Vomiting

    Coughing, choking and possibly vomiting. If obstruction is total - rapidly progresses to unconsciousness and cardiorespiratory arrest. May be present in a child in cardiorespiratory arrest and who it is impossible to ventilate. [rch.org.au]

    Dyspnoea, chest pain, wheezing, fever, nausea or vomiting may follow this. Lemberg et al ( 3 ) reported the following symptoms Figure 3 Physical examination may show no abnormalities in large proportion of these cases. [ispub.com]

    He denied any fever, chills, headaches, hemoptysis, nausea, vomiting, recent sick contacts, significant travel history, or exposure to allergens. [hindawi.com]

    Therefore, the possibility of an inhaled foreign body should always be considered when there is sudden onset of choking and intractable cough with or without vomiting. [patientcareonline.com]

  • Constipation

    Later symptoms and signs of ovarian cancer include: Ascites Pain with intercourse Pelvic pain or pressure Abdominal bloating and distension Gas and/or diarrhea Urinating frequently Constipation Constipation Changes in menstruation (period) Abnormal hair [emedicinehealth.com]

    […] may develop if cancer affects the: peritoneum liver lymphatic system ovaries breast bowel stomach pancreas lung womb Ascites is often painful and typically causes a person to feel: nauseated less hungry than usual tired breathless urinary urgency and constipation [medicalnewstoday.com]

Cardiovascular

  • Cyanosis

    Keywords: Balloon, Cyanosis, Foreign body aspiration, Respiratory distress Introduction Foreign body aspiration with subsequent airway obstruction typically occurs in children between the ages of six months and five years. [ncbi.nlm.nih.gov]

    Obstruction of the larynx or trachea is a potentially life-threatening situation that causes severe respiratory distress, cyanosis, and suffocation. [amboss.com]

    Respiratory distress, cyanosis. In cases of minor aspiration, unspecific symptoms comparable to those seen in respiratory infections. Pneumonitis after prolonged occlusion. Atelectasis after complete occlusion. Tracheal deviation, mediastinal shift. [kidsdoc.at]

    Other common signs are cyanosis, choking, and dyspnea. However, delays in presentation for care are common, and concern about aspiration as a cause of the child’s symptoms may diminish as the primary event becomes more distant. [dontforgetthebubbles.com]

  • Hypertension

    The patient was a 55-year-old male with no history of hypertension, diabetes, or pulmonary tuberculosis. About 5 years ago, he had an episode of choking while eating fish, and had suffered a chronic cough and sputum since that episode. [ekjm.org]

    It most commonly results from Portal hypertension—high blood pressure in the portal vein (the large vein that brings blood from the intestine to the liver) and its branches Portal hypertension usually results from cirrhosis (severe scarring of the liver [msdmanuals.com]

    Delivery Models Health Care Economics, Insurance, Payment Health Care Policy Health Care Quality Health Care Reform Health Care Safety Health Care Workforce Health Disparities Health Informatics Health Policy Hematology History of Medicine Humanities Hypertension [jamanetwork.com]

    The treatment of portal hypertension: a meta-analytic review. Hepatology. 1995 Jul. 22(1):332-54. [Medline]. [Guideline] Bruix J, Sherman M. AASLD practice guideline: management of hepatocellular carcinoma. Jul 2010. [medscape.com]

  • Heart Disease

    Benign ascites is generally caused by liver diseases (for example, liver cirrhosis) or heart diseases. [pfmmedical.com]

Musculoskeletal

  • Fracture

    A benign pleural effusion occurs, for example, as a result of left-sided heart failure, liver cirrhosis, fractured ribs or inflammations. [pfmmedical.com]

    People who receive abdominal thrusts may require further examination by a doctor to rule out any internal injuries, such as rib fractures or tears to the stomach.[35] Foreign body aspiration FAQs Q: What are the main symptoms of foreign body aspiration [ada.com]

  • Arthritis

    Validity of self-reported rheumatoid arthritis in a large cohort: results from the Black Women's Health Study. Arthritis care & research, 62(2), 235-41. https://doi.org/10.1002/acr.20073 Francis, A., Fink, M., Appiani, F., Bertelsen, A., Bolwig, T. [health.au.dk]

    Causes of malignant effusions include tumours in the body, for example cancer, pulmonary embolisms, a bacterial infection with pneumococci within the scope of pneumonia, or rheumatoid arthritis. [pfmmedical.com]

  • Back Pain

    Ascites may also cause bloating, abdominal and back pain, and lead to a person having difficulty sitting and moving. Share on Pinterest Liver disease is the leading cause of ascites. [medicalnewstoday.com]

Skin

  • Ulcer

    Histopathology revealed fungal organisms suggestive of Aspergillus within an ulcer of the adjacent bronchial mucosa. [ncbi.nlm.nih.gov]

    Cutaneous aspergillosis is usually the dermatological manifestation of IA that manifests as erythematous-to-violaceous plaques or papules, often characterized by a central necrotic ulcer or eschar. [orpha.net]

    […] found on either side with equal frequency </li></ul><ul><li>Once aspirated, objects may subsequently change position or migrate distally </li></ul><ul><li>The object itself might cause obstruction or induce inflammation, edema, cellular infiltration, ulceration [slideshare.net]

Psychiatrical

  • Fear

    Note however, that younger and preverbal children may not be able to volunteer a history and older children may be reluctant to do so for fear of reprimand or punishment. [caribbean.scielo.org]

Neurologic

  • Irritability

    Choking Coughing Irritability Wheezing Difficulty breathing or breathing trouble (respiratory distress) [childrens.com]

    Children may otherwise present with cough, dyspnea, or irritability 2,6. Most (70-90%) foreign bodies are organic, most commonly seeds and nuts. Inorganic foreign bodies vary dramatically and can include teeth, coins, pins, pens/crayons, etc. [radiopaedia.org]

    A hypothesis is those children might have experienced an event with a foreign body at the larynx, irritating the laryngeal and hypopharyngeal structures. [academic.oup.com]

    If the child has been febrile, it is important to consider the possibility that the object may be contaminated or chemically irritating.  The most tragic cases occur when acute aspiration causes total or near-total occlusion of the airway, resulting [slideshare.net]

  • Headache

    He denied any fever, chills, headaches, hemoptysis, nausea, vomiting, recent sick contacts, significant travel history, or exposure to allergens. [hindawi.com]

    Boy With Worsening Respiratory Function: A Case History A 6-year-old boy with well-controlled asthma presented to the emergency department (ED) with a 2-day history of fever, headache, productive cough, and dyspnea. [consultant360.com]

  • Dystonia

    Untreated patients characteristically develop dystonia during infancy resulting in a high morbidity and mortality. [max.book118.com]

Workup

Workup revealed air trapping and bronchoscopy showed aspirated foreign material in the right mainstem bronchus. Histopathology revealed fungal organisms suggestive of Aspergillus within an ulcer of the adjacent bronchial mucosa. [ncbi.nlm.nih.gov]

[…] reported that out of 27,381 US emergency department visits in 2013 for suffocation injuries, as assessed using the Nationwide Emergency Department Sample database, 14,140 (51.6%) resulted from inhalation and ingestion of food. [12] Differential Diagnosis Workup [emedicine.medscape.com]

Adult witness facilitates clinical workup and prevents delayed diagnosis, which is of high importance since the signs and symptoms of FBA simulate a number of pediatric diseases such as bronchiolitis, pneumonia, and asthma. [journals.sagepub.com]

“Foreign Body Aspiration Workup.” 31 December 2015. Accessed 14 January 2019. ↩ MSD Manual. “Bronchoscopy.” October 2016. Accessed 14 January 2019. ↩ Medscape. “Foreign Body Aspiration Treatment & Management.” 31 December 2015. [ada.com]

Treatment

The remaining 118 (53.6%) cases had a delayed treatment. [ncbi.nlm.nih.gov]

Review scheduled treatment with patient. Discuss and document the risks associated with treatment (and non-treatment). Have an appropriate informed consent document (per rule of law). [zyris.com]

Prognosis

Local environments have an important influence on the types of objects aspirated, location in the tracheobronchial tree, and prognosis. [emedicine.medscape.com]

Prognosis: Good, directly related to the timeliness of diagnosis and treatment. [kidsdoc.at]

Treatment and prognosis Bronchoscopy is considered the gold standard in the diagnosis of tracheobronchial tree foreign bodies 3, with the added benefit of being able to potentially retrieve the foreign body. [radiopaedia.org]

The positive predictive value for a single prognosis in this sample is 74% and the negative predictive value is 90%. We are unable to explain why hypersalivation as a pre-hospital symptom decreases the probability of an FBA. [academic.oup.com]

Etiology

The cases highlight that clinicians must remain vigilant for co-morbidities in an asthma exacerbation, and less common etiologies of PM and SCE, such as foreign body aspiration, should also be carefully considered in asthmatic children. [ncbi.nlm.nih.gov]

Etiology Pathophysiology Aspiration of a FB → airway obstruction Complete obstruction → collapse of the respiratory structures distal to the obstruction (e.g., atelectasis). [amboss.com]

The aim of our study was to determine the clinical spectrum, the demographic, and also the etiology of FBA in children. [erj.ersjournals.com]

On admission, a computed tomographic (CT) scan of the chest was obtained to search for another etiology of her exacerbated respiratory distress. CT results revealed a soft tissue density in the right lower lobe bronchus ( Figure 1 ). [aafp.org]

Epidemiology

Epidemiology References:[1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

OBJECTIVES: The objective of this study is to analyze the epidemiological, clinical, radiological and endoscopic characteristics of pediatric foreign body aspiration in Algeria. [ncbi.nlm.nih.gov]

Explore and learn more about Conference Series LLC LTD : World’s leading Event Organizer Back Biography Biography: Aderrahmane Boufersaoui Abstract Objectives: Th e objective of this study is to analyze the epidemiological, clinical, radiological and [pediatrics.conferenceseries.com]

Epidemiology Aspiration of foreign bodies by children can lead to serious illness and sometimes even death. [pedsinreview.aappublications.org]

Pathophysiology

Etiology Pathophysiology Aspiration of a FB → airway obstruction Complete obstruction → collapse of the respiratory structures distal to the obstruction (e.g., atelectasis). [amboss.com]

Pathophysiology <ul><li>Near-total obstruction of the larynx or trachea can cause immediate asphyxia and death </li></ul><ul><li>Should the object pass beyond the carina, its location would depend on the patient's age and physical position at the time [slideshare.net]

A high index of suspicion is required for prompt diagnosis.[ 7 ] Any patient who has a severe coughing fit after oral exposure to a high-risk object should be considered to have a bronchial foreign body until proven otherwise.[ 8 ] Pathophysiology Pathophysiological [bcmj.org]

Diagnosis was delayed by more than 24 hours in 60% of those particular cases. [3][4][5] Pathophysiology Young children are particularly at risk for foreign body aspiration. [ncbi.nlm.nih.gov]

Prevention

Primary and secondary prevention measures need to be implemented.10 We believe that at present, primary prevention is the key area in the fight against this problem. [analesdepediatria.org]

Reduction of these injuries by prevention can be achieved via parental education and avoidance of objects that produce the greatest risk [ 3 ]. [aclr.com.es]

Abstract Foreign body aspiration (FBA) is a preventable cause of mortality and morbidity in children. We conducted a chart review of children who presented to a university hospital due to FBA in the period 1999-2014. [ncbi.nlm.nih.gov]

Conclusion: Public awareness through mass media needs attention to prevent foreign body inhalation. High index of clinical suspician is mandatory for early diagnosis and management to prevent fatal outcome and long term morbidity (JPMA 49:33, 1999). [jpma.org.pk]

Choking and aspiration involve the interaction between an object and the airway in such a way as to prevent breathing from being fully effective. [accesspediatrics.mhmedical.com]

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