FOREIGN BODY ASPIRATION FOREIGN BODY ASPIRATION Foreign body aspiration is a lifethreatening emergency requiring immediate intervention The removal of a foreign body in the respiratory tract generally leads to a rapid recovery ID: 1043181
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1. FOREIGN BODIES
2. FOREIGN BODIESFOREIGN BODY ASPIRATION
3. FOREIGN BODY ASPIRATIONForeign body aspiration is a life-threatening emergency requiring immediate intervention.The removal of a foreign body in the respiratory tract generally leads to a rapid recovery
4. Age incidenceAge : 9 to 30 months due to children's mobility Oral exploration of the environmentOlder children and adults add to the problem by giving inappropriate foods
5. Factors that Make Young Children Susceptible to AspirationChildren often cry, shout, run, and play with objects in their mouthsAbsence of molars to chew certain foods adequatelyImmature coordination of swallowing and airway protectionImmature laryngeal sphincter control
6. Types of F.B Organic material Peanut Sunflower seedAlmondPopcornApple or Orange seeds Nonorganic Buttons Toys partsPins and needles
7. EvaluationThe most important factor in evaluating a child who possibly aspirated an FB is an accurate history.choking crisis occurred in 95%persistent cough, hemoptesis, fever, malaise, and respiratory compromiseInspiratory stridor and respiratory distress -larynx or subglottic area.Wheeze -Foreign bodies in the trachea or bronchus
8. SymptomsPenetration syndrome " defined as a sudden onset of choking and intractable cough with or without vomiting”CoughFeverBreathlessnessWheezingCyanosis No symptoms
9. Radiographic examination consists of anteroposterior and lateral views of the extended neck and chest.56% of patients will have a normal chest radiographCXR findings:air trapping : the most common signatelectasismediastinal shift Pneumoniaa radiopaque object
10. Radiographic Findings in Patients With Foreign Body Aspiration Adult Group, No. of Radiographs With Diagnosis (% Relative Frequency) Child Group, No. of Radiographs With Diagnosis (% Relative Frequency)9 (50%)11 (14%)Atelectasis3 (17%)49 (64%)Air trapping3 (17%) 10 (13%)Pneumonia2 (11%)3 (4%)Visible foreign body2 (11%)9 (12%)Normal radiograph
11. Air trapping
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15. Progress of diseaseSymptomatic phaseAsymptomatic phaseComplicationsPneumoniaLung abscessBronchiectasisHemoptasisErosion & perforation
16. signsRespiratory distressLocalized wheezingPoor air entry
17. Complications of aspirationobstruction due to granulation tissue or strictures, atelectasis,bronchiectasis, pneumonia,empyema, lung abscess, perforation with pneumothorax,systemic sepsis.
18. Special considerationGreat care needs to be taken with peanuts, which is why they should not be given to young children. Not only can they obstruct the bronchus, but the oil content can also produce a lipoid pneumonia which is known to develop rapidly.
19. treatmentBronchoscopic removal of the foreign body
20. ESOPHAGEAL FOREIGN BODIES
21. Esophageal FBThe most common site (70%) of lodgement is at the level of the cricopharyngeus muscle (the area between the clavicles on the x-ray). The other two sites of lodgement are mid-oesophagus the gastro-oesphageal junction.Coins and smooth blunt objects are the most commonly ingested items
22. Congenital and acquired esophageal anomalies that contribute to FB obstruction of the esophagus.Esophageal anastomosisvascular ring, esophageal stricture
23. Clinical symptomspain in the pharyngeal or retrosternal region, gagging poor feeding Drooling
24. Radiologic evaluation include a lateral view and an anteroposterior view of both the neck and chest
25. treatmentEsophagoscopic removal
26. Batteries unique injuriesRelated to:Direct caustic injury, alkaline corrosive tissue necrosis from electrical discharge, toxin release (mercury poisoning).Disc batteries can cause corrosive injury to the esophagus within 4 hours
27. Complications caused by esophageal impaction of button batteriesInclude: tracheoesophageal fistulaesophageal burn with and without perforation, Aortoesophageal fistula,esophageal stricture, death.
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29. treatmentEmergency endoscopy must be performed for batteries retained in the esophagus because of the high propensity of early mucosal injury.
30. GASTROINTESTINAL FOREIGN BODIES
31. 97% of ingested FBs that passed through the esophagus on radiographic study were spontaneously evacuated
32. typesSharp objectsBlunt objectsDisc batteriesmagnets
33. Sharp objectsMajority pass without problemsNeed careful observationSurgical intervention:PeritonitisBleedingObstructionFailure to progress
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35. Blunt objectsCoins; buttons; marblesMost of these objects pass Observation at home surgical intervention if complicated:PeritonitisBleedingObstructionFailure to progress within 4-6 weeks
36. Disc batteriesSerious complications because of Corrosive injuryElectric currentShould be removed if no progress within 6 to 12 hours
37. magnetsIngestion of multiple magnets causesbowel perforationvolvulusischemiaenteroenteral fistulas.
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39. Superabsorbent polymersToys and household products made of superabsorbent polymers present a risk for bowel obstruction if ingested These objects can expand 30 to 60 times in volume when hydrated If ingestion of a superabsorbent object is suspected, it should be removed immediately. If the object has passed beyond the stomach, the patient should be monitored for symptoms of intestinal obstruction