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Foreign body aspirations with rigid bronchoscopy and esophagoscopy in children
Hüseyin Fatih Sezer1, Aykut Eliçora1, Salih Topçu1
1Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye.
Insights
Foreign body aspirations and esophageal foreign bodies pose serious risks, especially in children. Prompt diagnosis and removal, often via endoscopy, are crucial for life-threatening cases, while many esophageal foreign bodies pass naturally.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Pulmonology
- Emergency Medicine
Background:
- Foreign body aspiration and esophageal foreign bodies are critical conditions with unknown incidence, predominantly affecting pediatric patients.
- Complications can lead to significant morbidity and mortality.
Purpose of the Study:
- To review the clinical features, diagnosis, and treatment of foreign body aspiration and esophageal foreign bodies.
- To highlight the differences in management between respiratory and esophageal foreign bodies.
Main Methods:
- Review of clinical presentations and diagnostic approaches for foreign body ingestion and aspiration.
- Discussion of endoscopic (bronchoscopy) and non-endoscopic (follow-up, maneuvers, surgery) treatment modalities.
- Emphasis on acute intervention for specific high-risk foreign bodies (magnets, batteries, sharp objects, expandable items).
Main Results:
- Respiratory foreign bodies typically require intervention, while most esophageal foreign bodies pass spontaneously.
- Endoscopic removal is standard for airway foreign bodies.
- Esophageal foreign body management includes observation, endoscopic removal, or surgery for obstructive, reactive, or sharp objects.
Conclusions:
- Early recognition and appropriate management, tailored to the location and type of foreign body, are essential.
- Increased awareness and proper parental guidance can reduce incidence and improve outcomes.
- Endoscopic procedures demonstrate high success rates with early postoperative discharge.
Abstract:
Foreign body aspirations and esophageal foreign bodies are lifethreatening conditions. Sometimes they or their complications can cause severe morbidity and even mortality. Their exact incidence is unknown. Foreign body aspirations and esophageal foreign bodies are most commonly observed in the pediatric age group. While interventions are generally required for the removal of respiratory tract foreign bodies, the majority of esophageal foreign bodies come out spontaneously. Removal of foreign bodies that block the lumen of the organ to a great extent, react with the mucosa such as battery magnets, and can cause poisoning, sharp-edged objects, and swellable foreign bodies such as legumes, should be done acutely. In the removal of foreign bodies, endoscopic methods (flexible/rigid bronchoscope) are used in the respiratory system. Other methods used in esophageal foreign bodies are follow-up and pushing and pulling maneuvers with equipment, and at times, open surgical procedures can be applied. The success of the procedures is high, and patients can be discharged in the early postoperative period. Their incidence can be decreased by raising awareness on the subject, parents can be prevented from making wrong applications in these cases, and clinicians can keep these conditions in mind in differential diagnosis. In this article, the clinical features and diagnosis and treatment methods of foreign body aspiration and esophageal foreign bodies will be discussed separately.
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