Outcomes of Impaction of Unusual Foreign Bodies in the Aero-digestive Tracts

Backgrounds: Foreign body aspiration and swallow is principal cause of accidental death in children. all foreign bodies should not be placed in the aero-digestive tracts but some are common to find others are not that common which confuse the thoracic surgeon while trying to extract them successfully.

Methods: A retrospective descriptive study from 2011 till 2015. Inclusion criteria were all patient with history or radiological evidence of foreign body aspiration or swallow on the esophagus that underwent at least a trial of extraction either via scope, open surgery or VATS. unusual foreign body was described as foreign body that found in less than 0.5% of cases.

Results: Eighteen different unusual foreign bodies were occurred in 35 patients including sharp bottle cover, hair clip, pressure pin, ear ring, part of endotracheal tube, common bile duct stent, magnet and others. Eleven were impacted in esophagus and 24 were inhaled. Failed first attempt for bronchoscopic extraction was occurred in 6 cases, 4 of them need surgery and 2 were succeeded in the second bronchoscopic trial. Cases required surgery were 2 sharp objects that can’t extracted safely via bronchoscopy and the other 2 were for slippery objects (marble ball and stone) that can’t be grasped via forceps.

Conclusion: Unusual foreign body that face thoracic surgeon can be troublesome with a higher than usual morbidities and need for surgery. Every attempt should be made for increase awareness among parents and primary health care doctors about the possibility of inhaled or swallow of such objects.