Foreign Bodies of the Aerodigestive Tract

Abstract

Foreign bodies of the aerodigestive tract are common in children. This review summarizes the epidemiology, presentation, anatomy, diagnosis, and treatment of ingested and aspirated foreign bodies, and highlights recent controversies in diagnosis and treatment. Providers continue to debate the best treatment for esophageal foreign bodies. For select patients awake bougienage or balloon catheter extraction affords the benefits of decreased length of stay and cost. Esophagoscopy is the only appropriate intervention for many patients and remains the most common treatment overall. Recent studies confirm traditional wisdom that suspected foreign body of the airway can only be excluded with bronchoscopy, despite some suggestion that computed tomography may be useful. Recent studies suggest that all patients with esophageal food impaction should undergo biopsy at time of endoscopy to exclude underlying esophageal pathology. Ultrasound may be useful in the diagnosis of radiolucent foreign bodies of the esophagus. Most foreign bodies of the aerodigestive tract are removed without harm to the child, but they can result in life-threatening complications. Pediatric providers should have a high degree of clinical suspicion for foreign bodies of the aerodigestive tract and make prompt referral for evaluation and treatment.