Clinical presentation, diagnosis and management of aerodigestive tract foreign bodies in the adult population: Part 1

Background: Aero-digestive foreign bodies are prevalent in our part of the country. Apart from the usual foreign body we encountered some unique foreign bodies, the diagnosis and management of which, is difficult due to varied and overlapping clinical presentation. Rare foreign bodies in the aero-digestive tract pose challenges in diagnosis and treatment.Methods: This was a retrospective observational study on thirty patients with aerodigestive foreign bodies who visited our hospital from July 2015 to October 2017. Results: Maximum number of cases was seen in age group of 0-5 years. The male to female ratio was 2:1. Among various types of foreign bodies, majority were metallic (43.3%). The most common site was cricopharynx (53.3%) followed by bronchus (26.6%) and esophageal (16.6%). The most common procedure done was hypopharyngoscopy (53.3%).Conclusions: Aerodigestive tract foreign bodies are one of the emergencies that have considerable mortality and morbidity. High degree of skill and suspicion are required by surgeon for the management of foreign body.

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Atypical Clinical Presentation of Laryngopharyngeal Reflux: A 5-Year Case Series

Journal of Clinical Medicine ◽

10.3390/jcm10112439 ◽

2021 ◽

Vol 10 (11) ◽

pp. 2439

Author(s):

Jerome R. Lechien ◽

Stéphane Hans ◽

Francois Bobin ◽

Christian Calvo-Henriquez ◽

Sven Saussez ◽

...

Keyword(s):

Clinical Presentation ◽

Laryngopharyngeal Reflux ◽

Case Series ◽

Clinical Findings ◽

Aerodigestive Tract ◽

Common Disease ◽

Upper Aerodigestive Tract ◽

Suppurative Otitis Media ◽

Adequate Treatment ◽

Atypical Clinical Presentation

Background: Laryngopharyngeal reflux (LPR) is a common disease in otolaryngology characterized by an inflammatory reaction of the mucosa of the upper aerodigestive tract caused by digestive refluxate enzymes. LPR has been identified as the etiological or favoring factor of laryngeal, oral, sinonasal, or otological diseases. In this case series, we reported the atypical clinical presentation of LPR in patients presenting in our clinic with reflux. Methods: A retrospective medical chart review of 351 patients with LPR treated in the European Reflux Clinic in Brussels, Poitiers and Paris was performed. In order to be included, patients had to report an atypical clinical presentation of LPR, consisting of symptoms or findings that are not described in the reflux symptom score and reflux sign assessment. The LPR diagnosis was confirmed with a 24 h hypopharyngeal-esophageal impedance pH study, and patients were treated with a combination of diet, proton pump inhibitors, and alginates. The atypical symptoms or findings had to be resolved from pre- to posttreatment. Results: From 2017 to 2021, 21 patients with atypical LPR were treated in our center. The clinical presentation consisted of recurrent aphthosis or burning mouth (N = 9), recurrent burps and abdominal disorders (N = 2), posterior nasal obstruction (N = 2), recurrent acute suppurative otitis media (N = 2), severe vocal fold dysplasia (N = 2), and recurrent acute rhinopharyngitis (N = 1), tearing (N = 1), aspirations (N = 1), or tracheobronchitis (N = 1). Abnormal upper aerodigestive tract reflux events were identified in all of these patients. Atypical clinical findings resolved and did not recur after an adequate antireflux treatment. Conclusion: LPR may present with various clinical presentations, including mouth, eye, tracheobronchial, nasal, or laryngeal findings, which may all regress with adequate treatment. Future studies are needed to better specify the relationship between LPR and these atypical findings through analyses identifying gastroduodenal enzymes in the inflamed tissue.

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The value of cervical MRI in surgical lumbar canal stenosis patients

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00249-1 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Omar Youssef Abdalla ◽

Hieder Al-Shami ◽

Heba Medhat Maghraby ◽

Abdelrhman Enayet

Keyword(s):

Clinical Presentation ◽

Adult Population ◽

Cervical Canal ◽

Lumbar Stenosis ◽

Cervical Stenosis ◽

Lumbar Canal Stenosis ◽

Cervical Canal Stenosis ◽

Canal Stenosis ◽

Tandem Spinal Stenosis ◽

A Prospective Study

Abstract Background The prevalence of cervical canal stenosis alone is estimated to be present in 4.9% of the adult population. Co-existence of dual pathology may complicate clinical presentation and necessitates a wise and individually based decision process. Objectives To estimate the co-existence of cervical canal stenosis in surgical lumbar canal stenosis patients and its reflection on decision-making regarding surgery. Methods It is a prospective study that was conducted on 70 cases with symptomatic lumbar canal stenosis by investigating them for cervical canal stenosis clinically and radiologically. Results The co-existence of cervical and lumbar canal stenoses was seen in 62 cases (88.57%); cases with relative cervical stenosis were 25 (35.714%) and absolute cervical stenosis was 37 (52.857%). Cases with no cervical stenosis were 8 (11.428%) and cases with relative lumbar stenosis were 22 (31.428%), while cases with absolute lumbar stenosis were 48 (68.571%). Cases with symptomatic cervical canal stenosis were 30 (42.857%). Cases with asymptomtic cervical canal stenosis were 32 (45.71%). Conclusion Tandem spinal stenosis (TSS) is not uncommon and MRI cervical spine should be done for every lumbar canal stenosis patient especially if indicated by history or clinical examination.

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Diagnosis and Management of Gastrointestinal Foreign Bodies

Gastroenterology Research and Practice ◽

10.1155/2016/5692650 ◽

2016 ◽

Vol 2016 ◽

pp. 1-2

Author(s):

Kenya Kamimura ◽

David C. Evans ◽

Ken-ichi Mizuno ◽

Juan E. Sola

Keyword(s):

Foreign Bodies ◽

Diagnosis And Management ◽

Gastrointestinal Foreign Bodies

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Management of Foreign Bodies in the Aerodigestive Tract

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-011-0436-y ◽

2012 ◽

Vol 66 (S1) ◽

pp. 220-224 ◽

Cited By ~ 9

Author(s):

Inès Hariga ◽

Khaled Khamassi ◽

Sarra Zribi ◽

Mohamed Ben Amor ◽

Olfa Ben Gamra ◽

...

Keyword(s):

Foreign Bodies ◽

Aerodigestive Tract

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Lipoma of the left tonsillar fossa

The Journal of Laryngology & Otology ◽

10.1017/s0022215100127252 ◽

1994 ◽

Vol 108 (6) ◽

pp. 507-508 ◽

Cited By ~ 6

Author(s):

R. Benson-Mitchell ◽

N. Tolley ◽

C. B. Croft ◽

D. Roberts

Keyword(s):

Adipose Tissue ◽

Connective Tissue ◽

Literature Review ◽

Clinical Presentation ◽

Aerodigestive Tract ◽

Upper Aerodigestive Tract ◽

Tonsillar Fossa ◽

Subcutaneous Tissues

AbstractLipomas are common benign connective tissue tumours composed of adult adipose tissue. They are relatively rare in the upper aerodigestive tract, although they occur with considerable frequency in other areas, particularly in the subcutaneous tissues of the neck. Although there are several reports of this tumour occurring in the oropharynx, there is no recorded case of a lipoma of the tonsillar fossa. An 83-year-old man with a left tonsillar fossa lipoma is presented. Clinical presentation, management and a literature review are discussed.

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Unsuspected Foreign Bodies of the Aerodigestive Tract

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947808700409 ◽

1978 ◽

Vol 87 (4) ◽

pp. 515-518 ◽

Cited By ~ 9

Author(s):

William Banks ◽

William P. Potsic

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Chart Review ◽

Foreign Bodies ◽

Failure To Thrive ◽

Late Complications ◽

Aerodigestive Tract ◽

Endoscopic Removal ◽

Children's Hospital ◽

Prolonged Duration

The well-known tendency for children to place loose objects in their months not infrequently leads to the entrapment of foreign bodies in the aerodigestive tract. With prompt and adequate removal few complications occur. However, when the foreign body goes undetected or is neglected the patient may develop dysphagia, pneumonia, failure to thrive, lung or mediastinal abscesses, bronchopulmonary or bronchoesophageal fistulas, or erosion of major vessels. Fifteen cases of retained foreign bodies were identified in a chart review between 1971 and 1977 at the Children's Hospital of Philadelphia, calling attention to the problems of aerodigestive foreign bodies of prolonged duration. Early and late complications are discussed and early diagnosis and endoscopic removal emphasized.

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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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