DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20203565

Pediatric aero-digestive foreign bodies in the emergency setup: an otorhinolaryngologist’s perspective

Abhilasha Goswami, Hironya Borah

Abstract


Background: The objective of the study was to investigate cases of foreign bodies in the aero-digestive tract among the paediatric population.

Methods: This study was carried out under the aegis of the department of otorhinolaryngology over a one-year period, from April 2019 to March 2020. A total of 82 paediatric patients presented to the emergency department with aero-digestive foreign body, where opinion of the otorhinolaryngologist was sought. All the patients were initially stabilised and assessed clinically. Detailed history was obtained, thorough clinical evaluation done and necessary investigations including radiological tests were performed. After ascertaining the nature and location of the foreign body, prompt removal of the same was done in all the patients under general anaesthesia.

Results: A total of 82 children presented to the emergency with history of inhalation/ingestion of foreign body or suspicion of such, and requiring otorhinolaryngological intervention. There were 55 boys and 27 girls, with 74 cases of ingestion and 8 cases of aspiration of foreign body. The most common foreign body ingested was coin and the most common foreign body aspirated was small button battery.

Conclusions: Foreign bodies in the aero-digestive tract are a common problem encountered by the otorhinolaryngologist in the emergency setup. It constitutes a health hazard in all age groups, but more so among the paediatric population, requiring effective management and immediate intervention. Careful clinical and radiological evaluation followed by prompt removal of the aero-digestive foreign body is essential to reduce the morbidity and mortality. Prevention and public education are the most vital and ideal management for this serious problem.


Keywords


Foreign body, Endoscopy, Esophagoscopy, Otorhinolaryngology

Full Text:

PDF

References


NCI Dictionary of Cancer Terms. National Cancer Institute. Available at: https://www.cancer.gov /publications/dictionaries/cancer-terms/def/aero- digestive-tract. Accessed on 25 May 2020.

Denney W, Ahmad N, Dillard B, Nowicki MJ. Children will eat the strangest things: a 10 year retrospective analysis of foreign body and caustic ingestions from a single academic center. Pediatr Emerg Care. 2012;28(8):731-4.

Hesham A, Kader H. Foreign body ingestion: children like to put objects in their mouth. World J Pediatr. 2010;6(4):301-10.

Lemberg PS, Darrow DH, Holinger LD. Aerodigestive tract foreign bodies in the older child and adolescent. Ann Otol Rhinol Laryngol. 1996; 105:267-71.

Conners GP, Chamberlain JM, Weiner PR. Pediatric coin ingestion: a home based survey. Am J Emerg Med. 1995;13(6):638-40.

Karakoc F, Cakir E, Ersu R, Uyan ZS, Colak B, Karadag B, et al. Late diagnosis of foreign body aspiration in children with chronic respiratory symptoms. Int J Pediatr Otorhinolaryngol. 2007;71:241-6.

Bittencourt PF, Camargos PA, Scheinmann P, De Blic J. Foreign body aspiration: Clinical, radiological findings and factors associated with its late removal. Int J Pediatr Otorhinolaryngol 2006;70:879-4.

Esclamado RM, Richardson MA. Laryngotracheal foreign bodies in children. A comparison with bronchial foreign bodies. Am J Dis Child 1987;141:259-62.

Rothmann BF, Boeckman CR. Foreign bodies in the larynx and tracheo bronchial tree. Ann Otol Rhinol Laryngol. 1980;89:434-6.

Brown TC, Clarck CM. Inhaled FB in child-ren. Medical Journal Australia. 1983;2:322-6.

O’Neil JA, Jr. Holdomb CW, Jr. Neblett WW. Management of tracheobronchial & Oesophageal foreign bodies in childhood. J Paediatric Surg. 1983;18:475-9.

Chevalier J, Jackson L. Diseases of the air and food passages of foreign body origin. WB Saunders & Co. Ltd. Philadelphia and London. J Laryngol Otol. 1936;51(12):824-5.

Fleischer K. Erkennung und Entfernung Von. Bronchial-frem-dkorpern einstJetzt. Ther-Ggegenw. 1974;113:348-58.

Committee on Injury, violence, and poison prevention. Policy statement-prevention of choking among children. Pediatrics. 2010;125 (3):601-7.