What are foreign bodies in the aerodigestive tract?

Foreign materials, such as food, toys and other small objects can get lodged in the airway or esophagus as a result of inhalation or swallowing. These objects can end up anywhere in the upper airways or the upper digestive tract, including the nose, throat, the esophagus, the trachea (windpipe) or the smaller air passages in the lungs called bronchi. Children under three years of age are particularly prone to such accidents. Close supervision is needed to avoid these accidents. Small toys should not be given to young children (check warning labels). Nuts, sunflower seeds, raw carrots and popcorn kernels are inappropriate foods for young children. Children can die from foreign body aspiration, and prompt treatment is urged. Prevention is the key!

Symptoms

• Trouble breathing
• Trouble speaking
• Drooling, vomiting
• Stomach and chest pains
• Coughing
• Wheezing, especially when only one side of the chest is affected
• Cyanosis (bluish skin) due to lack of oxygen
• Pneumonia that will not improve

If your child’s airway is partially blocked — marked by difficulty breathing, wheezing and/or bluish skin — call 911 or go to the nearest emergency room, as these may be signs of airway obstruction. If the object is stuck in the nose, the following signs may develop:

• Bad smelling mucus or bloody discharge from one side of the nose
• Difficulty breathing through the nose

Diagnosis

Diagnosis may include a physical examination, radiographs and bronchoscopy and or esophagoscopy in the operating room.

Treatment

Treatment depends on the cause of the blockage. Call your pediatrician and go to the emergency room for evaluation and treatment.

• Heimlich maneuver is needed to expel a foreign object caught in the airway with life-threatening airway blockage.
• Objects lodged in the airway may be removed under anesthesia in the operating room with a laryngoscope or bronchoscope.
• A tube may be inserted into the airway.
• Direct opening into the airway (tracheostomy or cricothyrotomy) may be needed.
• Swallowed foreign bodies can be removed under anesthesia with an esophagoscope.

When to Call for Help

If you suspect that a foreign object is lodged in your child’s airway, call 911 or go to the nearest emergency room.