Diagnosis and Management of Upper Aerodigestive Tract Foreign Bodies

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Although often listed together in review articles and case series, tracheobronchial and esophageal foreign bodies can be dissimilar. Airway foreign bodies can range widely in the severity of presentation. When to proceed with a diagnostic bronchoscopy is not always obvious and is based on three diagnostic tools: clinical history, physical examination, and radiography. Radiography plays a more central role in the diagnosis of an esophageal foreign body. In either condition, a delay in diagnosis leads to a greater complication rate. This article provides diagnostic and treatment guidelines in the management of aerodigestive foreign bodies.

Section snippets

Airway foreign bodies

Airway foreign bodies (AFBs) have remained a diagnostic challenge to health care professionals. They can become life-threatening emergencies that require immediate intervention or can go unnoticed for weeks and even months. Every effort must be made to avoid a delay in diagnosis because this may lead to a notable increase in complication rates [1]. A sudden onset of respiratory symptoms must alert the clinician to the presence of an AFB. This section presents an overview of the assessment and

Esophageal foreign bodies

Esophageal foreign bodies (EFBs) are considered less precarious than AFBs. Even so, they occur more frequently and are responsible for over 1500 deaths per year [15]. Anatomically, these foreign bodies are commonly found at the cricopharyngeus, at the crossover of the aortic arch at midesophagus, and at the lower esophageal sphincter.

Patients who have EFBs can be loosely classified into four groups: (1) pediatric patients, (2) psychiatric patients and prisoners, (3) patients who have underlying

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