Foreign Body Impaction in the Larynx, Trachea, and Bronchi

Overview

Foreign body impaction in the larynx, trachea, and bronchi is a serious medical condition that requires prompt attention. It can cause significant morbidity and mortality if not managed properly.

Types of Foreign Bodies

Common types of foreign bodies that can become impacted in the larynx, trachea, and bronchi include:

1. Food particles: Peanuts, seeds, and other small objects.
2. Small objects: Coins, marbles, and other small toys.
3. Organic materials: Vegetable or animal matter.

Epidemiology

Foreign body aspiration is more common in:

1. Children:

Particularly those under 3 years old.
2. Adults with altered mental status:

Such as those with neurological disorders or substance abuse.

Pathophysiology

Foreign body impaction occurs when an object becomes lodged in the airway, potentially causing:

1. Obstruction: Partial or complete blockage of the airway.
2. Inflammation: Swelling and irritation of the airway tissues.

Investigations

Symptoms and signs

1. Coughing: Sudden onset of coughing or choking.
2. Difficulty breathing: Wheezing, stridor, or respiratory distress.
3. Cyanosis: Bluish discoloration of the skin due to inadequate oxygenation.

Investigations

1. Chest X-ray:

To identify radiopaque foreign bodies or signs of airway obstruction.
2. Computed Tomography (CT) scan:

To provide more detailed images of the airway and foreign body.
3. Bronchoscopy

To visualize the airway and foreign body directly.

Complications of Foreign Body Impaction

1. Respiratory failure: Due to airway obstruction or inflammation.
2. Pneumonia: Infection of the lung tissue.
3. Lung damage: Chronic inflammation or scarring.

Management

1. Bronchoscopy:

To remove the foreign body and restore airway patency.
2. Endotracheal intubation:

To secure the airway and ensure adequate oxygenation.

Special Situation

Managing a Long-Standing Impacted Foreign Body

1. Granulation tissue formation

May require additional treatment, such as antibiotics or anti-inflammatory medications.
2. Empyema thoracis

May require drainage of the pleural space.
3. Lung collapse

May require bronchoscopy or other interventions to re-expand the lung.

Preventive Measures

1. Supervise children: During meals and playtime.
2. Avoid giving small objects: To children.
3. Chew food thoroughly : To reduce the risk of aspiration.

Foreign body impaction in the larynx, trachea, and bronchi is a serious medical condition that requires prompt attention. Prompt recognition and management can help prevent complications and improve outcomes.

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