Foreign bodies in upper aero-digestive tract: a clinical study.

ABSTRACT

Background: Foreign-body ingestion and aspiration are common childhood adverse events, hence are commonest causes of morbidity and mortality in infants and children worldwide. Aim of current study was to identify the patients with foreign-body ingestion and aspiration, develop a suitable algorithm for their management and study various complications following their removal. Methods: The present study was carried out in G.R. medical college, Gwalior, M. P. during last one year on hundred patients diagnosed as case of foreign-body in upper aero-digestive tract on the basis of history, examination and investigations. Results: Foreign-bodies in upper aero-digestive tract were seen mostly in children less than 10 years of age (91%). The youngest was 8 months old and the oldest 48 years. Coins were the most common foreign-bodies in oesophagus (90%) while whistle in the upper airway (40%). Right bronchus is the commonest site of impaction in the airway (50%), while cricopharynx is most common in the oesophagus (95.55%). Patients with oesophageal foreign bodies presented mostly with the chief complaint of foreign body sensation (63.4%) in the throat whereas those with airway foreign body presented mostly with dyspnoea and choking sensation (60%). Pooling of saliva was most commonly seen in patients with oesophageal foreign bodies (43.3%). Tachypnoea was the most common sign in cases of tracheabronchial foreign bodies (80%). Positive radiological evidence was present in 88% of upper aero-digestive foreignbodies. Only 2.2% cases showed complications following oesophagoscopy. Tracheo-bronchial foreign-bodies were removed by emergency bronchoscopy. 20% cases had complications post-operatively. Conclusion: Early detection by meticulous history, imaging modality & prompt management remains basis for favourable outcome and prevents fatal complications.