2. INHALED FOREIGN BODY
• Any F.B passing through the aerodigestive tract (mouth /nose) either passes down to esophagus or
• Pass through the glottis in to the bronchi(inhaled)
• Although large F.B. or sharp F.B. rarely get impacted in the larynx
3. INCIDENCE
• Child/mentally retard adults but also may occur in normal adult
• TYPES
• A)VEGETABLE FB-seeds, peanuts
• B)Non – Vegetable FB- pins,glass beads,plastic,buttons…
5. SEQUALAE
• When inhaled –FB reaches the larynx it is either:-
• 1)coughed outside
• 2)impacted in the larynx(laryngeal FB) or
• 3)inhaled inside the tracheobronchial tree (bronchial FB)
6. LARYNGEAL F.B. AKA CAFÉ CORONARY CHOCKING
• TYPES-A) sharp FB (B)large FB
• Clinical picture:- sudden violent attack of coughing and choking
• A)with large FB there will complete laryngeal obstruction->reflex laryngeal spasm->severe stridor-
>asphyxia and cyanosis ->DEATH
• B) with small FB- laryngeal obstruction and stridor is more gradual due to overlying edema
7. TREATMENT
FIRST AID
• A)infant and child- BACK BLOWS
• INFANTS-hold the infant with his legs with head down and give sharp slap on the back(with the heel of
hand)
8. • B)children- sit down and put the child on your knees in prone position with head below the level of
chest and give sharp slap between the scapula…
9. ADULTS
• A)back blows—make patient to lean forward so that head becomes below the level of chest and give
sharp slap on back (not the face) between scapulae.
• B)HEIMLICH maneuver
15. SITE OF IMPACTION
• Usually impacts in the right main bronchus being wider and more in line with the trachea
• However , it may remain in the trachea or pass down in to small bronchi
16.
17. CLINICAL MANIF..(INITIAL,LATENT,MANIFEST)
• A)initial stage
• Sudden onset of severe paroxysmal cough, dyspnea and cyanosis and sometimes expectoration of
blood stained secretions.
• This occurs at the time of inhalation of FB.
• This history is usually given by parents of child but may pass unnoticed if the child was not supervised.
18. LATENT STAGE
• A variable free interval during which there may be mild paroxysmal cough and expectoration(length of
this duration depends upon size and type of FB.
• An organic FB gives rise to inflammatory changes and secondary infection early while metal FB doesn’t
cause much irritation.
20. MECHANICAL OBSTRUCTION
A)complete obstruction B)partial obstruction
-Pulmonary collapse (atelectasis) FB act as one way valve(pulmonary
emphysema)
Symptoms- Symptoms-
Dyspnea, cough, expectoration Dyspnea , cough , expectoration
Signs- Signs-
Dullness on percussion Hyperresonance on percussion
Shift of mediastinum to the same side of
collapse
Shift of mediastinum to the opposite side
of collapse
Decreased tactile vocal fremitus Increased tactile vocal fremitus
No air entry on the affected side on
auscultation
U/L localizes continuous wheeze and
diminished air entry on auscultation
21. INFLAMMATORY CHANGES
• An organic FB excites severe irritation and inflammatory reaction(to its fatty acids) leading to severe
bronchitis, bronchopneumonia, atelectasis and lung abscess.
• Non organic FB lead to little or no inflammatory rxn.
22. INVESTIGATIONS
• Xray- neck AP and lateral
-chest(inspiratory and expiratory)
-may show radio opaque(some time radiolucent) with or without secondary effects (collapse
/emphysema)
.C.T – can be done in limited cases
.virtual bronchoscopy
