Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body

Summary. Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. Objective. We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. Case report. A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. Conclusion. Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.

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Endobronchial Foreign Body Presenting as Exacerbation of Asthma

Case Reports in Emergency Medicine ◽

10.1155/2017/6863083 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

James E. Tsang ◽

June Sun ◽

Gaik C. Ooi ◽

Kenneth W. Tsang

Keyword(s):

Foreign Body ◽

Respiratory Distress ◽

Foreign Bodies ◽

Main Bronchus ◽

Fiberoptic Bronchoscopy ◽

Clinical History ◽

Medical Personnel ◽

History Of ◽

Normal Chest ◽

Low Dose Computed Tomography

Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a “LEGO” toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy. Our case serves to reemphasize the importance of considering airway foreign bodies as a cause of respiratory distress, especially in young children.

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Foreign bodies in esophagus: our experiences

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20184692 ◽

2018 ◽

Vol 5 (1) ◽

pp. 83

Author(s):

A. G. Naveen Kumar

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Medical Science ◽

Final Diagnosis ◽

Retropharyngeal Abscess ◽

Research Centre ◽

Esophageal Foreign Body ◽

History Of ◽

Age Range ◽

Time Of Admission

Background: Foreign bodies in esophagus come as an emergency to otolaryngologist and needs to be removed at the earliest to prevent complications. The objective was to share our experience with esophageal foreign bodies removal in Sapthagiri Institute of Medical Science and Research Centre, Bangalore, India.Methods: Study of 84 patients admitted with the final diagnosis of esophageal foreign body during September 2011 – September 2018, for sex, age, diagnosis on admission, estimated duration and site of impaction, type and number of foreign body removed. Results: Over 7 years period, 84 patients (48 males and 36 females) of different ages, youngest being 02 years and oldest being 92 years were admitted with the diagnosis of esophageal foreign body. Fifty percent of patients were five years or less in age at the time of admission. 32.1% were between 5 to 14 years and 17.9% were between the age range of 60-92 years. Seven patients (2.9%) had a history of esophageal anomalies requiring operation. Different types of foreign bodies ingested most common being coin. Majority of foreign bodies (75/84, 89.2%) were located in the post cricoid and upper esophagus followed by the mid-esophagus, and only 3 cases involved the lower esophagus.Conclusions: The most common foreign bodies in children are coin and toys. Sharp foreign bodies are difficult remove but need to be removed carefully at the earliest to prevent dreaded complications like - retropharyngeal abscess and mediastinitis. Loose fitting dentures are common foreign body in elderly patients.

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Management of oesophageal foreign bodies in pediatric patients: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212454 ◽

2021 ◽

Vol 7 (7) ◽

pp. 1164

Author(s):

Manit M. Mandal ◽

Ajay J. Panchal ◽

Rakesh Kumar ◽

Parth B. Kapadia ◽

Vipul Valiya ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Pediatric Patients ◽

Demographic Data ◽

Complete Recovery ◽

Clinical Problem ◽

Tertiary Hospital ◽

Battery Cell ◽

Presenting Symptoms ◽

History Of

Background: Amongst pediatric patients, oesophageal foreign bodies (OFBs) are relatively common clinical problem. Majority pass harmlessly through gastrointestinal tract, some can cause complications or morbidities. Our study considered and reviewed our experience in managing OFBs in pediatric patients, with emphasis on the management and outcomes of complicated cases.Methods: 77 cases of OFBs (diagnosis established), upto 12 years of age admitted at our tertiary hospital between January 2015 to December 2020 (duration of 6 years) were reviewed and analysed. On the basis of our analysis accounting demographic data, presenting symptoms, workup investigation, management, complications and outcomes, results and conclusions were derived.Results: Amongst cases, 43 were male and 34 female. Mean age for our cases was 5.4 years. 56 cases (72.7%) cases presented in the hospital within first 24 hours. Commonest foreign body found in 64 cases (83.1%) was coin. Most cases had history of witnessed ingestion. Commonest presentation was asymptomatic (with history of witnessed ingestion), followed by complaint of vomiting and drooling of saliva. Most patients were discharged within 48 hours post-operatively except for 2 patients who presented intra-operatively with edematous inflamed mucosa with slight charring on oesophagoscopy where foreign body was button battery (cell). Follow-up period ranged from 2 to 8 months and all patients had complete recovery without any sequelae.Conclusions: Our experience of 6 years with 77 pediatric patients with OFBs having various presentations have been reviewed, analysed and concluded here. All the patients had complete recovery without any sequelae.

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Esophageal Foreign Body Causing Direct Aortic Injury

Canadian Journal of Gastroenterology ◽

10.1155/2003/948232 ◽

2003 ◽

Vol 17 (2) ◽

pp. 115-117 ◽

Cited By ~ 16

Author(s):

ECS Lam ◽

JA Brown ◽

JS Whittaker

Keyword(s):

Foreign Body ◽

Esophageal Perforation ◽

Foreign Bodies ◽

Aortic Injury ◽

Fish Bone ◽

Aortoesophageal Fistula ◽

Esophageal Foreign Body ◽

Arterial Bleeding ◽

History Of ◽

Tomography Scan

Foreign bodies in the esophagus are uncommon causes of esophageal perforation. Many nonperforating cases are successfully managed by flexible gastroscopy. However, complicated foreign bodies such as those that result in esophageal perforation and vascular injury are best managed surgically. Gastroscopy remains the primary method of diagnosis. A case of a 59-year-old woman who developed retrosternal and intrascapular pain, odynophagia and hematemesis after eating fish is reported. Flexible gastroscopy showed arterial bleeding from the midthoracic esophagus. Computed tomography scan localized a 3 cm fish bone perforating the esophagus with surrounding hematoma. An aortogram did not reveal an actively bleeding aortoesophageal fistula. The fish bone was surgically removed and the patient recovered with no postoperative complications. This case illustrates the importance of early consideration for surgical intervention when confronted with a brisk arterial bleed from the esophagus with suggestive history of foreign body ingestion.

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Karakteristik pasien benda asing trakeobronkial di bagian T.H.T.K.L Rumah Sakit Dr. Mohammad Hoesin Palembang

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v47i2.225 ◽

2018 ◽

Vol 47 (2) ◽

pp. 164

Author(s):

Puspa Zuleika ◽

Abla Ghanie

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Tracheobronchial Tree ◽

Foreign Body Aspiration ◽

The Body ◽

X Rays ◽

X Ray ◽

Tracheobronchial Foreign Body ◽

History Of ◽

Chest X Ray

Latar belakang: Aspirasi benda asing ialah masuknya benda yang berasal dari luar atau dalam tubuh, ke saluran trakeobronkial. Aspirasi benda asing saluran trakeobronkial merupakan keadaan darurat yang memerlukan tindakan bronkoskopi segera untuk mencegah komplikasi yang lebih serius. Tujuan: Mengidentifikasi karakteristik klinis pasien aspirasi benda asing saluran trakeobronkial di bagian Telinga Hidung Tenggorok – Bedah Kepala Leher (T.H.T.K.L) Fakultas Kedokteran Universitas Sriwijaya/ Rumah Sakit Dr. Mohammad Hoesin Palembang. Metode: Penelitian ini merupakan penelitian observasional deskriptif. Sampel penelitian ini diambil dari data rekam medis pasien aspirasi benda asing pada saluran trakeobronkial di Rumah Sakit Dr. Mohammad Hoesin Palembang periode Januari 2012 - Desember 2016. Hasil: Didapatkan 20 pasien dengan riwayat teraspirasi benda asing di saluran trakeobronkial. Dijumpai 9 orang laki-laki dan 11 orang perempuan dengan perbandingan 1:1,2, di mana usia 0-15 tahun merupakan penderita terbanyak aspirasi benda asing ini. Benda asing yang paling banyak ditemukan adalah mainan dan benda plastik sebanyak 9 kasus, serta jarum pentul sebanyak 6 kasus. Sebanyak 19 pasien diketahui terdapat riwayat tersedak benda asing. Pemeriksaan foto toraks menunjukkan gambaran normal pada 12 pasien. Lokasi benda asing terbanyak ditemukan di trakea sebanyak 8 kasus. Kesimpulan: Aspirasi benda asing di saluran trakeobronkial sering terjadi pada anak-anak yang berusia kurang dari 15 tahun. Benda asing terbanyak adalah anorganik berupa mainan dan benda plastik. Pemeriksaan radiologi paru dalam 24 jam pertama setelah kejadian aspirasi pada umumnya menunjukkan gambaran normal. Lokasi benda asing di saluran trakeobronkial terbanyak pada penelitian ini adalah di trakea. Kata kunci: Aspirasi, bronkoskopi, foto toraks, benda asing, traktus trakeobronkial ABSTRACT Background: Foreign body aspiration is the entrance of foreign objects from outside or inside of the body into the tracheobronchial tract. Aspiration of foreign body in tracheobronchial tract is an emergency condition that needs immediate bronchoscopy procedure to prevent serious complications. Objectives: To identify clinical characteristics of foreign body aspiration patients in ENT Department Sriwijaya Medical Faculty / Dr. Mohammad Hoesin Hospital, Palembang. Method: This study was a descriptive observational study. The sample of this study was taken from the medical record of tracheobronchial foreign body aspiration patients at Dr. Mohammad Hoesin Hospital from January 2012 until December 2016. Result: There were twenty patients with the history of foreign body aspiration in tracheobronchial tract, consisted of 9 male and 11 female, with the ratio 1:1,2, in which 0–15 year-old children were the majority of the patients. The most common foreign bodies were toys and plastic objects in 9 cases and head veil pin in 6 cases. Nineteen cases of the patients had the history of choking as presenting symptom. Chest X-Ray showed normal imaging on twelve patients. The most common site in tracheobronchial tract where foreign bodies found was the trachea, in eight cases. Conclusions: Foreign body aspirations in tracheobronchial tract were most frequently happened in children less than 15 year-old. The most common foreign bodies were anorganic material, such as toys and plastic objects. Lung X-Rays on the first 24 hours commonly showed normal imaging. Foreign bodies in tracheobronchial tracts most frequently were found in the trachea. Keywords: Aspirations, bronchoscopy, chest X-Ray, foreign body, tracheobronchial tree

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Impacted Metallic Spring Requiring Cervical Esophagotomy: A Case Report and Review of the Literature on Foreign Body Removal

Case Reports in Gastrointestinal Medicine ◽

10.1155/2017/5468131 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

Patrick Stoner ◽

Eric Hilgenfeldt ◽

Alexander Schlachterman

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Surgical Intervention ◽

Thoracic Esophagus ◽

Unique Case ◽

Foreign Body Removal ◽

Endoscopic Techniques ◽

Successful Removal ◽

Upper Thoracic ◽

Upper Gastrointestinal

Foreign body ingestion is a commonly encountered problem and can cause significant morbidity and mortality. When removal of a foreign body from the upper gastrointestinal tract is indicated, endoscopy is the modality of choice and has a high reported success rate. However, in less than 1% of cases, endoscopic removal of a foreign body is unsuccessful and surgical intervention is necessary. We report a unique case of a large, sharp metallic spring swallowed by an incarcerated patient which subsequently became lodged in his upper thoracic esophagus. This spring was unable to be removed endoscopically due to risk of perforation and cervical esophagotomy was needed for its successful removal, illustrating the limitations of endoscopic techniques in removal of foreign bodies and the role surgical intervention has in these rare instances.

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Chronic retained esophageal foreign body: a case report

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20210135 ◽

2021 ◽

Vol 8 (2) ◽

pp. 383

Author(s):

Gurpreet Singh Chhabra ◽

Anumeet Singh Grover ◽

Gagandeep Kaur

Keyword(s):

Case Report ◽

Foreign Body ◽

Respiratory Symptoms ◽

Foreign Bodies ◽

Gastrointestinal Symptoms ◽

Esophageal Foreign Body ◽

High Incidence ◽

History Of ◽

Foreign Body Impaction ◽

Esophageal Foreign Bodies

Chronic esophageal foreign bodies (CEFB) are associated with a high incidence of morbidity and mortality in adults. However, the presentation, management and outcome of chronic esophageal foreign bodies in children are not well described. Seventy-six percent of patients presented with a primary complaint of respiratory symptoms, with respiratory distress being the most common followed by asthmatic symptoms and cough. Twenty-two percent of patients had primarily gastrointestinal symptoms including nausea, vomiting and dysphagia. We present a case report of 2year 6month old male with 3 months history of cough and vomiting later diagnosed to be a case of upper esophageal foreign body impaction.

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Foreign Body Aspiration: Potential Cause of Coughing and Wheezing

Pediatrics in Review ◽

10.1542/pir.10.2.59 ◽

1988 ◽

Vol 10 (2) ◽

pp. 59-63

Author(s):

H. James Holroyd

Keyword(s):

Foreign Body ◽

Respiratory Symptoms ◽

Foreign Bodies ◽

Pediatric Population ◽

Congenital Defects ◽

Natural Tendency ◽

History Of ◽

Possible Cause ◽

Cardiopulmonary System ◽

Infants And Young Children

As many as half of routine ill-patient visits in pediatrics practice involve respiratory symptoms. It is not surprising that we see so much coughing and wheezing when we consider that children are still developing immunologically and are, therefore, more susceptible to infection. In early life, most of these infectious diseases occur in the respiratory and gastrointestinal tracts. In addition, the gradual exposure of the constitutionally allergic child to environmental allergens pre-disposes to the development of respiratory symptoms. Childhood is also a time for congenital defects of the cardiopulmonary system to become apparent. A sometimes overlooked cause of respiratory symptoms in infants and young children—and one that can become rapidly and severely complicated if misdiagnosed—is the aspiration of foreign bodies. Aspiration or ingestion of foreign bodies remains a significant cause of morbidity and mortality in the pediatric population. Children between 8 months and 4 years of age are at highest risk. Not all cases of aspiration are of the acute, obstructive variety, and pediatricians should consider a foreign body as a possible cause of coughing and wheezing even when no definite history of aspiration is obtained. Children of course are curious and their natural tendency is to reach out and explore new objects. Bringing objects to their mouths to taste and to test textures is common.

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Occult Liver Abscess Following Clinically Unsuspected Ingestion of Foreign Bodies

Canadian Journal of Gastroenterology ◽

10.1155/1997/815876 ◽

1997 ◽

Vol 11 (5) ◽

pp. 445-448 ◽

Cited By ~ 27

Author(s):

Ban CH Tsui ◽

J Mossey

Keyword(s):

Foreign Body ◽

Preoperative Diagnosis ◽

Foreign Bodies ◽

Clinical Presentation ◽

Computed Tomographic ◽

Liver Abscesses ◽

Computed Tomographic Scan ◽

History Of ◽

Variable Clinical Presentation

Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gut with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.

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Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience

10.21203/rs.3.rs-41995/v3 ◽

2020 ◽

Author(s):

Bo Liu ◽

Fengxia Ding ◽

Yong An ◽

Yonggang Li ◽

Zhengxia Pan ◽

...

Keyword(s):

Foreign Body ◽

Medical Records ◽

Foreign Bodies ◽

Pediatric Patients ◽

Previous History ◽

Rigid Bronchoscopy ◽

Diagnostic Difficulties ◽

History Of ◽

Male Patients ◽

Symptoms And Signs

Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

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