Endoscopic removal of foreign bodies from the upper aerodigestive tract: a retrospective study from a tertiary care hospital

Sreeja Raj Vellamparambil; Arjun Gopinath Menon; Ariyamparambil Rajagopalan Vinayakumar

doi:10.18203/issn.2454-5929.ijohns20192712

Authors

Sreeja Raj Vellamparambil Department of Otorhinolaryngology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India
Arjun Gopinath Menon Department of Otorhinolaryngology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India
Ariyamparambil Rajagopalan Vinayakumar Department of Otorhinolaryngology, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20192712

Keywords:

Aerodigestivetract, Bronchoscopy, Oesophagoscopy, Foreign body

Abstract

Background: Foreign bodies (FB) in the upper aero-digestive tract pose major challenges to the otorhinolaryngologist in both diagnosis and management. Aspirated and ingested foreign bodies are often emergencies, leading to inadequate study, poor preparation and improper attempts at removal. A retrospective analysis was done on cases which were managed for the upper aero-digestive tract FBs in a tertiary care hospital in South India and the result is presented in this article.

Methods: Retrospective study was done on 100 patients diagnosed as cases of foreign body in upper aerodigestive tract on the basis of detailed history, clinical examination and radiological investigation. They underwent per oral endoscopy under general anaesthesia for retrieval of foreign body.

Results: Age group more prone for foreign body ingestion or aspiration was <10 years and >50 years. Most common site of impaction in oesophagus is cricopharynx and in airway is right bronchus. Most common type of FB is chicken bone. Most common symptom in FB ingestion is FB sensation and in case of FB aspiration it is cough. Most (82%) of the FBs were radio opaque.

Conclusions: Accurate history and clinical examination were the keystones in diagnosis and prevention of complications of FB lodgement in aerodigestive tract. Negative history and or normal imaging do not rule out a foreign body.

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References

Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin N Am. 1996;14:493–521.

Samad L, Ali M, Ramzi H. Button battery ingestion:hazards of esophageal impaction. J Pediatr Surg.1999;34:1527–31.

Tucker JG, Kim HH, Lucas GW. Esophageal perforation caused by coin ingestion. South Med J. 1994;87:269–72.

Jackson C, Jackson, CL. Diseases. In: Jackson C, Jackson, CL (eds.). Diseases of the Air and Food Passages of Foreign Body Origin. 1st edition. Philadelphia: Saunders; 1936: 1-635.

Boyd AD. Chevalier Jackson: the father of American bronchoesophagoscopy. Ann Thorac Surg. 1994;57:502-5.

Kim IG, Brummitt WM, Humphrey A, Siomra SW, Wallace WB. Foreign bodies in the airway—a review of 202 cases. Laryngoscope. 1973;83:347- 54.

Banerjee S. Concept of the foreign body—its past and present. Indian J Otolaryngol Head Neck Surg. 1999;51:23-30.

Stevens C, Ardagh M, Abbott GD. Aerodigestive tract foreign bodies in children. One year’s experience at Christchurch hospital emergency department. N Z Med J. 1996;109:232-3.

Banerjee A, Rao KS, Khanna SK, Narayanan PS, Gupta BK, Sekar JC, et al. Laryngo-tracheo-bronchial foreign bodies in children. J Laryngol Otol. 1988;102:1029–32.

Zerella JT, Dimler M, McGill LC, Pippus KJ. Foreign body aspiration in children: value of radiology and complications of bronchoscopy. Paediatr Surg. 1998;33:1651-4.

Hassan AM, Ghosh P, Menon PSN, Kaul HL, Mukhopadhaya S. Changes in tracheobronchial angles as a function of age. Indian J Otolaryngol Head Neck Surg. 1993;2:1–6.

Wood RE. Pediatric bronchoscopy; rigid versus flexible bronchoscopy (pro-flexible bronchoscopy). J Bronch. 1996;3:156–60.

Holinger LD. Pediatric bronchoscopy; rigid versus flexible brochoscopy (pro-rigid bronchoscopy). J Bronch. 1996;3:153–5.

Wilson RT, Dean PJ, Lewis M. Aortoesophageal fistula due to a foreign body. Gastrointest Endosc. 1987;33:448–50.

Bakara A, Bikhazi G. Oesophageal foreign bodies. BMJ. 1975;1:561–3.

Friedman EM. Foreign bodies in the pediatric aerodigestive tract. Pediatr Ann. 1988;17:640–7.

Ballenger Jr S. Otorhinolaryngology head & neck surgery. 15th edition. PMPH USA, Ltd; 1996: 1189- 1222.

Mu L, He P, Sun D. The causes and complications of late diagnosis of foreign body aspiration in children. Report of 210 cases. Arch Otolaryngol Head Neck Surg. 1991;117:876–9.

Morioka WT, Maisel RH, Smith TW, Cantrell RW. Unexpected radiographic findings related to foreign bodies. Ann Otol Rhinol Laryngol. 1975;84:627.