Foreign body aspiration
Patients will present with stridor, wheezing, and respiratory distress often of acute onset following the aspirating event. Decreased breath sounds localized to the side of the obstructing object can sometimes be appreciated. The blockage caused by a foreign body can result in tracheal injury, pneumonia, pneumonitis, lung abscesses, bronchiectasis, or hemoptysis.
Patients will often present with acute symptoms and require urgent if not emergent bronchoscopy for removal of the foreign body. If patients are unable to be adequately oxygenated or ventilated, emergent intubation may be required.
Despite advances in foreign body removal, bronchoscopy, and public health efforts to raise awareness about potential risks and measures to avoid aspiration (especially in children), foreign body aspiration remains a common cause of emergency visits and is a leading cause of unintentional injury-related death in the United States.
T17.908A – Unspecified foreign body in respiratory tract, part unspecified causing other injury, initial encounter
278696005 – Aspiration of foreign body into lower respiratory tract
Differential Diagnosis & Pitfalls
- Allergic reaction / anaphylaxis
- Retropharyngeal abscess
- Pneumonitis (eg, hypersensitivity pneumonitis)
- Pulmonary abscess
- Chronic obstructive pulmonary disease
- Pulmonary embolism
- Vocal cord dysfunction or paralysis
- Vascular ring