Thumbtack in Bronchus
How many of us have held a thumbtack between our lips, while hanging posters on the wall?
In each of these cases, the foreign body was carefully removed under general anaesthesia and the patient had a full recovery.
These cases are presented for educational purposes only, in the hope that many future cases of choking will be prevented.
How many of us have held a thumbtack between our lips, while hanging posters on the wall?
Nuts are one of the most common bronchial foreign bodies in children. Peanuts create more bronchial inflammation than any other food.
Coins are the most common foreign body requiring removal under general anaesthesia.
Disc batteries are one of the most dangerous choking hazards, because they can burn through the esophagus (in as little as 2 hours) and cause a serious chest infection.
Chewing on the cap (or other loose part) of a pen or pencil is dangerous, especially if your chair tips backwards and makes you gasp.
The point of an open safety pin needs to be gently disengaged from the wall of the esophagus, before it can be removed.
This pendant was removed from the lower esophagus, using optical forceps. Toddlers have also swallowed rings and earrings.
The metal “stopper” from a screen door became a bronchial foreign body. Any hardware that’s in the hand of an infant or toddler (or is held between the lips of someone “on the job”) can be inhaled and block a bronchus.
Holidays are usually happy times, but can also pose special choking risks.
In a matter of seconds, one or more objects in a toddler’s hand can lodge in a bronchus.
Plastic Lite Brite pegs have similar aerodynamic properties; thus they also have become bronchial foreign bodies.
This coat button, embedded with rhinestones, was more difficult to remove from the esophagus than a coin.
Sunflower seeds are commonly “husked” within one’s mouth. This can be dangerous (even for professional athletes), especially if one stumbles or is surprised and gasps for air.
A teenager removed the metal clip from a plastic pen cap, folded it in half, and accidentally swallowed it when his chair tipped backwards. The bent metal clip was removed from his upper esophagus.
A 4 mm diameter chunk of crayon was inhaled and lodged in a toddler’s bronchus. It was removed with the “Vancouver” forceps, which was designed to remove very small bronchial foreign bodies.
A thin metal bristle can break off a barbecue brush, stick to the grill, and then enter a piece of food. In this case, a bristle lodged in the base of a teenager’s tongue.
A “button backing” is a type of textile hardware. This object was inhaled by a toddler and lodged in the right main bronchus.
A butterfly-shaped plastic sticker became stuck between a toddler’s vocal cords. This caused a weak, hoarse cry; noise when breathing both in and out; and a cough that sounded like a dog or a seal barking (similar to croup).
It’s never a good idea to put anything made of metal or plastic completely inside your mouth.
This pebble was inhaled by a young child at a school playground. Because it was partially radiopaque, it can be seen faintly on the xray, blocking the right main bronchus.
A toddler swallowed this “figure skate” charm. It was removed from the esophagus under general anaesthesia.
Cutting food into small pieces is usually helpful, but sometimes a toddler, with multiple pieces of food in his/her mouth, will cry then gasp for air. In this case, 9 small pieces of bacon needed to be removed.
A young child had a coughing fit right after a molar had been extracted. 12 days later, fever and worsening cough prompted him to visit the ER.
This “propeller” from a Kinder Surprise airplane was nearly swallowed. After some retching, was propelled upward, into a toddler’s nasopharynx (behind the soft palate).
The majority of deaths from choking and suffocation occur in the first year of life.[Ref:43]