Foreign Body Aspiration

Foreign body aspiration (thesaurus synonyms: Asphyxia due to foreign body; Asphyxia due to foreign body in bronchus; Asphyxia due to foreign body in larynx; Asphyxia due to foreign body in larynx; Asphyxia due to foreign body in nasopharynx; Asphyxia due to foreign body in pharynx; Asphyxia due to foreign body in pharynx; Asphyxia due to foreign body in airway; Asphyxia due to foreign body in bronchioles; Asphyxia due to foreign body in trachea; Asphyxia due to foreign body in lungs; Asphyxia due to foreign body in sinus; Asphyxia due to foreign body in trachea; Asphyxia due to food; Asphyxia due to nasal foreign body; Asphyxia due to nostril foreign body; Airway foreign body; Bronchial foreign body; Asphyxia due to foreign body; Asphyxia due to inhalation of oil; Asphyxia due to food a. n.k. ; Asphyxiation by regurgitated food; Fluid aspiration; Fluid inhalation; Foreign body aspiration; Foreign body in antrum highmori; Foreign body in main bronchus; Foreign body in hypopharynx; Foreign body in larynx; Foreign body in nasopharynx; Foreign body in pharynx; Foreign body in respiratory tract; Foreign body in pharynx; Foreign body in piriform sinus; Foreign body in bronchioles; Foreign body in maxillary sinus; Foreign body in lungs; Foreign body in frontal sinus; Foreign body inhalation; Inhalation of vomit; Inhalation of stomach contents; Inhalation of food; Inhalation of mucus; Inspiration of food; Laryngeal foreign body; Tracheal foreign body; Food aspiration; Nasal foreign body; Sinus foreign body; Pharyngeal foreign body; Food aspiration; Tracheal foreign body; ICD-10-GM T17. -: Foreign body in the respiratory tract) is when a foreign body enters the larynx (voice box), trachea (windpipe), or bronchi. It can remain in the upper airway blocking the larynx, restricting airflow. However, it can also penetrate into the deeper airways, which improves breathing again. Foreign body aspiration is among the more common suspected diagnoses in pediatric medicine (pediatrics). However, foreign body aspiration can also occur in adults, for example in cases of unconsciousness or neurological deficits in which the swallowing act is disturbed. Commonly aspirated foreign bodies include:

  • Foods such as nuts (very commonly peanuts), pumpkin and sunflower seeds, grapes, carrots, candy
  • Toy parts, e.g. Lego bricks, marbles, contents of surprise eggs, glass eyes of dolls/stuffed animals
  • Commodities such as screws, buttons

In young children, the foreign bodies aspirated are food in 75% of cases. In older children, toy parts, needles and nails are in the foreground. 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

Sex ratio: boys are more often affected than girls. Frequency peak: foreign body aspiration occurs mainly in infancy, that is, between six months and 5 years. However, it mainly affects children between the ages of 2 and 3 years. Approximately 1 in 1,000 children per year aspirates a foreign body. If a foreign body aspiration is suspected, the pediatrician should always be consulted, since an imminent suffocation can never be ruled out. If necessary, the pediatrician will refer the child to a hospital. Both diagnosis and therapy should be interdisciplinary! The course and prognosis are significantly influenced by the size of the foreign body, shape and material. The foreign body can be removed by gagging or coughing, which are natural reflexes. If the patient gasps for breath or if the skin is already cyanotic (bluish discoloration), it is an acute emergency! Often aspirated objects remain asymptomatic at first, but may become problematic after two to three hours. The more time between the event and diagnosis, the greater the risk for complications.If an aspirated foreign body is removed within 24 hours with normal oxygenation of the affected person, there is usually no secondary damage. If it remains in the body longer, granulations (connective tissue) may form around the foreign body, making removal more difficult. Chronic foreign body aspiration (> 2 days) can lead to permanent damage to the lungs.If there is complete obstruction of the trachea (windpipe), permanent damage can be expected due to the resulting hypoxia (lack of oxygen supply to the tissue). Foreign body aspiration can also lead to death close to the event (3.4% of cases), especially in children under one year of age. Foreign bodies may remain lodged in the bronchial tree undetected for years or even migrate within it.