A RARE CASE OF AIRWAY FOREIGN BODY (CEMENT & SAND)
Airway Foreign Body
An object is considered a "foreign body" (FB) if the object is in a location in the body where it is not normally found. Common foreign bodies found in children include coins, small toys, foods (like peas, beans, nuts, or even candy), and, other small objects like beads or pills, dislodged teeth , even bugs, may be found. Probably the most concerning object is a button type battery (like camera and watch batteries), as these can leak harmful substances [1-3]. Foreign body occurrence is a commonest cause of accidental home death in the children under 6 years of age in USA . Children are in a habit of putting every thing in there mouth to detect the taste and texture especially around teething age. Depending on the size, shape and type of FBs, they can impact in the larynx, trachea or more distally to bronchi. Children may experience symptoms differently; some children can even have vague symptoms that do not immediately suggest ingestion. The clinical presentation varies from acute severe respiratory syndrome to clinically no obvious signs. Usually the laryngeal and tracheal FBs are fatal and produce sign and symptoms of sever choking. While the more distal FBs usually present with more variable forms, starting from acute severe respiratory distress to minor wheeze. They may present in the form of persistent or recurrent pneumonia. Other may lie silent and are diagnosed accidentally on diagnostic bronchoscopy. Long standing FBs especially of organic in origin may present with haemoptysis. Parents should suspect their child might have swallowed a foreign object if breathing or swallowing difficulties persist longer than two weeks despite medical treatment. For example, continuing asthma or upper respiratory treatment without seeing improvement [1-4]. Radiological findings vary from absolutely normal X-ray chest to emphysema, collapse of lung to opaque FBs . The management of the FB varies depending upon the severity of the symptoms , site of impaction & type of the FBs. Tracheal & laryngeal FBs usually present in emergency conservative measures like Hemlich’s may be tried but one should not persistent with this method after the 4th try. The gold standard principal of FBs management is bronchscopic removal .Even the most experienced endoscopists would agree that the prospect of having to deal with a very young child with a history of possible inhalation of FB fills them with some trepidation- not only because of the demands that the removal of a FB makes on their skill as an endoscopist, but also because of the unpredictability in the degree of difficulty in the nature of the procedure [6-7].