Aspirative foreign body converted in ingested foreign body

• Summary
• Introduction

CASE REPORT

Summary:

A 9 year old boy presented in ent clinic with the
diagnosis of bronchial foreign body. A bronchoscopy was performed
and a foreign body was seen in the left main bronchus, during the
removal procedure the foreign body went down and became
imperceptible so the procedure was stoped and treatment was
prescribed. A chest x ray was ordered two days later and it was
normal.an abdomen x ray was ordered too and it showed the foreign
body in the rectum.

Introduction

The human body is provided with number of defense
mechanisms to keep the airway free and clear of extraneous
matter.these include the physical actions of the epiglottis and
aritenoid cartilages in blocking the airway,intense spasm of the
true and false vocal cords any time objects come near the vocal
cords and a highly sensitive cough reflex wich afferent impulses
generated throughout the larynx, trachea and all branch points in
the proximal tracheobronchial tree.however nobe of these
mechanisms is perfect and foreign bodies frequently lodge in the
airways of children.

Children are more prone to aspirate foreign material for
several reasons.the lack of molar teeth in children decreases
their ability to chew food sufficiently, leaving larger chunks of
food.the propensity of children to talk,laugh and run around
while chewing also increases the chance thet a sudden or large
inspiration may occur with food in the mouth.children often
examine even nonfood substances with their mouth.

The peak ages during which aspiration of foreign bodies
are the toddler through preschool ages, although foreign bodies
have been found in the airways of individuals of all ages and
sizes. Even relatively immobile infants are not immune, despite
not having the ability to crawl and find things or the ability to
pick up objets and put them in the mouth.

Case report

A 9 year old school boy was brought to the ent clinic
because a day before he was holding a piece of wire in his mouth
then sddenly he started and swallowed the piece of wire a dry
cough.

The ent examination was unremarkable.

Respiratory system: rr:16xmin with no retraction.breath
sounds slightly decreased in the left lung.there were no
stertores.

The rest of physical examination was
unremarkable.

A chest x-ray was ordered and it showed a metallic
foreign body in the left main bronchus.

The patient was admitted with a diagnosis of bronchial
foreign body and a bronchoscopy was arranged for next morning.the
bronchoscopy was performed and the foreign body was located in
the left main bronchus.during the removal procedure the foreign
body went down and became imperceptible.the operation was
stopped. So treatment with teophiline and hydrochertizone was
prescribed.the child was still asymptomatic.a new chest x-ray was
ordered two days later, the result was normal.an abdominal x-ray
was also ordered, it showed the metallic foreign body in the
rectum.