Update in the extraction of airway foreign bodies in adults

Abstract

Foreign body (FB) aspiration into the airway is lees common in adults than children.Nevertheless its incidence does not decrease through time. We present clinical relevant aspects of airway FBs on the basis of a selective review of pertinent literature retrieved by a search in the PubMed database.The most common aspirated FBs by adults are organics, especially fragments of bones and seeds. Symptoms usually are cough, chocking and dyspnea. Right localization, especially bronchus intermedius and right lower lobe, is more frequent. Chest radiography can be normal in up to 20% of the cases and FBs can be detected in 26% of the patients. FBs can safely remove in the majority of patients under flexible bronchoscopy.Surgical treatment must be reserved for cases in which bronchoscope fails or there are irreversible bronchial or lung complications.

Foreign Body Aspiration in Adult, What Would You Expect? Case Report

“…Our presented case had altered sensorium with low GCS which was the predisposing factor of his aspiration. The majority of FBs become lodged in the right bronchial tree, favoring the bronchus intermedius and the basal segments of the right lower lobe, owing to a more vertical course of the right mains stem bronchus (1,5,6) , and our presented case showed clearly the same finding of right bronchus intermedius location of the FB.…”

“…Standard postero-anterior and lateral chest radiographs should be obtained in all patients in whom FB aspiration is suspected. Radiographs directly identify the FB in 25% of patients, as only a minority of FBs such as coins, nails, teeth, or dental appliances are radiopaque (1,6) . Most FBs are organic and radiolucent (such as food), and therefore not directly visible on chest radiograph (2.7) .…”

Utility of bronchoscopy combined with surgery in the treatment and outcomes of dogs with intrathoracic disease secondary to plant awn migration

“…[19][20][21][22]35 This is similar to man, presumably because of linearity with the trachea and large luminal diameter of the right bronchus. 28,29,36,37 The only bronchoscopic-related complication in this cohort was the failure to retrieve visualized MPA from the accessory bronchus in two cases and the left caudal bronchus in one case. The authors speculate that the smaller luminal size and anatomic orientation relative to other bronchi made retrieval from the accessory bronchus technically more challenging, likely contributing to the failed attempts at retrieval.…”

A Huge Fishhook in the Right Main Bronchus

“…Aspiration of a foreign body must always be treated immediately, because it may traumatize the lining mucosa or cause airway obstruction, atelectasis, bronchiectasis, obstructive pneumonia and lung abscess [1]. Our patient experienced some of the symptoms of foreign body aspiration as cough and hemoptysis but by the time of bronchoscopy, there was no evidence of infection at the site of the fishhook.…”