Foreign body aspiration often goes unnoticed (asymptomatic) at first. Symptomatology depends on the type, nature, as well as location of the foreign body and how much time has elapsed between aspiration and diagnosis.
The following symptoms and complaints may indicate foreign body aspiration:
Leading symptoms
- Sudden onset of irritating cough attacksNote: If the foreign body slips into the deeper airways, it no longer triggers a coughing impulse.
- Gagging – when the foreign body is still in the larynx (voice box)/pharynx (throat) area.
Other symptoms
- Sudden dyspnea (shortness of breath), cyanosis (bluish discoloration of skin and central mucous membranes, e.g., tongue), asphyxia (threatened suffocation) – if large bronchi are obstructed; if the foreign body slips further, symptoms may subside again
- Whistling breathing sound (stridor; abnormal breathing sounds due to narrowing of the airways).
- Wheezing: unilateral/side difference.
- Sudden onset asthma symptomatology without underlying asthma disease (often unilateral).
- Atypical attack of pseudocroup without underlying pseudocroup.
According to the symptomatology, a distinction is made between:
- Acute: < 24 hours after the event
- Subacute: > 24 hours after the event
- Chronic: weeks, months after the event
Localization of the aspirated foreign body:
- Oral cavity, pharynx (throat; supraglottic/above vocal folds): 1-2%.
- Larynx (larynx; subglottic/below the glottis): 5-10%.
- Bronchi (trunk, segmental, subsegmental bronchi): 90-95% – twice as common in sections of the right bronchial tree
- Terminal bronchi (bronchioli terminales) and their fine branches (bronchioli respiratorii) and intraalveolar (within a pulmonary alveolus (alveolus)): 1-2%.
