Incidence, patterns and different modalities in extraction of aero-digestive tract foreign bodies in patients attending Alexandria Main University Hospital

Background

Aero-digestive tract foreign bodies (FB) are commonly seen either in children or in elderly age group. Various methods have been described in literature for their removal. In our study we aimed to analyze the incidence, risk factors, site, clinical presentations, different modalities used to extract tracheobronchial and esophageal foreign bodies in patients presented with FB aspiration or ingestion to the Emergency, Cardiothoracic Surgery, ENT and Chest disease departments in Alexandria Main University Hospital during the period between 1-11-2014 to 1-11-2015.

Methods

A review of ninety patients with alleged FB aspiration and one hundred patients with alleged FB ingestion underwent complete history taking including personal data, date of presentation, date of aspiration or ingestion, circumstances of aspiration or ingestion, and past history of any previous medical or surgical conditions. Clinical assessment included vital signs and complete physical examination & investigations e.g.; complete blood count, random blood sugar, coagulation profile, renal function tests and liver function tests. Imaging including plain X-ray, CT scan, ultrasound, and virtual bronchoscopy were done. Some patients underwent rigid esophagoscopy/bronchoscopy under general anesthesia, based on clinical and radiological evidence. Some patients underwent surgical interventions.

Results

Regarding FB aspiration, we found that sex difference was statistically significant in teenagers and adult group; females were found to be more commonly affected than males. Also most of cases of pin aspiration were teenagers (>10–20 years) and adults (>20 years). We noticed that right main bronchus FB was found more frequently in children below 10 years. Rigid bronchoscopic extraction of the FBs was the most common modality of extraction seen in 70 patients (77.8%). Regarding FB ingestion we noticed that females were commonly affected than males, coins were the most commonly ingested FB; and upper oesophageal sphincter (UES) was the commonest site of FB entrapment.

Conclusions

FBs in the aero-digestive tract constituted a constant hazard in all age groups especially in children and the elderly, which demanded immediate action and management.