This document discusses foreign bodies in the digestive tract, including inhaled and swallowed foreign bodies. It notes that inhaled foreign bodies most often affect young children under 4 years old and can cause respiratory obstruction or death if lodged in the larynx. Symptoms of inhaled foreign bodies include coughing, wheezing, and asymptomatic periods followed by obstruction. Swallowed foreign bodies are also more common in young children and the elderly, with coins and bones being common objects. Symptoms include dysphagia, odynophagia, and neck or chest pain. Diagnosis involves imaging and endoscopy may be used for removal. Complications can include esophageal perforation requiring antibiotics and possibly surgery.

1. Foreign Bodies Aero
Digestive tract
Dr. Junaid Shahzad
MBBS, FCPS
Senior Registrar
ENT department
ANMCH Isra University

2. • Inhaled Foreign bodies
• Swallowed Foreign bodies

3. Inhaled Foreign bodies
• Over 75% are children aged 4 years or under.
• Features of Foreign body inhalation are dependent on its types and location
in laryngo-tracheo-bronchial tree.
• Vegetable material like peanuts, seeds and popcorn produces a severe
mucosal reaction in comparison to inorganic material like coins and buttons.

6. Clinical features
• Impaction in larynx can cause complete respiratory obstruction and
can be fatal.
• The Heimlich manoeuvre may dislodge the object.
• Alternative airway like cricothyrotomy or tracheostomy can also be performed
and foreign body can be removed endoscopically

9. Trachea and Bronchus
• Choking
• Coughing with wheezing
• Tracheal B/L wheeze
• Bronchus unilateral wheeze
• After initial attack patient can remain asymptomatic for days, weeks and
months.

10. Cont.
• Symptoms manifest's only as a consequence of mucosal reaction producing
obstruction.
• Vegetable foreign body generally present earlier because of this
physiological response.
• Healthy child suddenly developing wheeze should always be considered for
inhaled foreign body.
• Unilateral wheeze, poor chest movement and reduced breath sounds.

11. Investigations
• Chest X-ray
• HRCT chest

14. Treatment
• Micro-laryngoscopy
• Bronchoscopy

17. Swallowed Foreign Body
• Mostly seen in younger age group, but may be encountered in the elderly
and psychiatrically disturbed patients.

18. Commonly Swallowed foreign
bodies
• Coins
• Fish Bones
• Meat bones
• Lumps of meat
• Dentures

19. Site of impaction
• Posterior Tongue
• Vallecula
• Tonsils
• Piriform fossa
• Cricopharyngeus muscle
• Aorta and Left main bronchus
• Cardiac sphincter

20. Clinical Features
• Acute Dysphagia
• Odynophagia
• Hyper-salivation
• Otalgia
• Neck tenderness
• Fever
• Neck emphysema- Rupture of esophagus

21. Visualization
• Oral examination
• Indirect Laryngoscopy
• Endoscopy
• X-ray

25. Treatment
• Angled forceps like telly's forceps.
• Food bolus- sedatives are given initially to encourage the bolus to pass on.
• If bone is involved they should be removed at the earliest by Endoscopy to
prevent oesophageal perforation.

26. Underlying Pathology

27. Oesophageal perforation
• Pain in neck, chest and back
• Pyrexia
• Tachycardia and dyspnoea
• Surgical emphysema

28. Treatment of Oesophageal
perforation
• Nil by mouth
• I/V line
• Broad spectrum anti-biotics
• X-ray with water soluble contrast like Gastrografin
• Surgical intervention

29. Thankyou