Large bodies may lodge at the level of the larynx or trachea and cause acute obstruction. Smaller bodies yield varied symptoms, depending on where in the respiratory tree they lodge and how long they have been present. Complaints may include dyspnea, chest pain, or cough, and the patient may be hypoxemic on occasion. Chest radiographs may show an object if it is radiopaque and may also show a pneumonic process distal to the obstruction, with associated atelectasis. Treatment consists of removal with rigid or flexible bronchoscopy by an experienced endoscopist along with assistance from an anesthesiologist.
Antibiotics are only necessary if there are radiologic signs of pneumonia.
Humidification, oxygenation, bronchodilation, and sometimes 24-48 hours of steroids after removal are helpful. Very common objects include coins, small batteries, and food. As most objects are radiopaque, a chest film often locates the suspected part. If a suspected object is radiolucent, a thin barium swallow may be performed to help locate it. Frequently these may lodge in the esophagus at either the level of the thoracic inlet, the area where the esophagus crosses the aorta, or the gastroesophageal junction.