Foreign body aspiration is the inhalation of a foreign body into the airway (ie, tracheal, laryngeal, or bronchial foreign body). It can cause life-threatening airway obstruction. Young children under the age of 4 years and adults with underlying neurologic diseases are at highest risk for foreign body aspiration. Poultry and fish bones are commonly aspirated food items.

Patients will present with stridor, wheezing, and respiratory distress often of acute onset following the aspirating event. Decreased breath sounds localized to the side of the obstructing object can sometimes be appreciated. The blockage caused by a foreign body can result in tracheal injury, pneumonia, pneumonitis, lung abscesses, bronchiectasis, or hemoptysis.

Patients will often present with acute symptoms and require urgent if not emergent bronchoscopy for removal of the foreign body. If patients are unable to be adequately oxygenated or ventilated, emergent intubation may be required.

Despite advances in foreign body removal, bronchoscopy, and public health efforts to raise awareness about potential risks and measures to avoid aspiration (especially in children), foreign body aspiration remains a common cause of emergency visits and is a leading cause of unintentional injury-related death in the United States.

Related topics: foreign body in esophagus, upper airway obstruction