# Foreign Body Aspiration — GCMD Library living collection

Everything in the library about foreign body aspiration — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 18 cited statements

## Episodes
### Diagnosis & Workup
- [A systematic review and meta-analysis of computed tomography in the diagnosis of pediatric foreign body aspiration](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971) — video · [machine version](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971.md)
- [Una revisión sistemática y metanálisis de la tomografía computarizada en el diagnóstico de aspiración de cuerpo extraño pediátrico](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972) — video · [machine version](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972.md)

### In-Depth Reviews
- [Airway and esophageal foreign bodies: Update Course 2015](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875) — video · 44:16 · [machine version](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875.md)

## Chapters
- [0:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=0) Introduction and airway foreign body imaging (Ep 1)
- [7:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=420) Button battery ingestions: recognition and urgency (Ep 1)
- [15:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=900) Batteries in the stomach: to scope or not to scope (Ep 1)
- [25:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1500) Magnet ingestions: single vs. multiple (Ep 1)
- [32:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1920) Coin ingestions and Foley catheter extraction (Ep 1)
- [40:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2400) Miscellaneous topics and case discussion (Ep 1)
- [0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0) CT Accuracy for Foreign Body Aspiration Diagnosis (Ep 2)
- [0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0) CT diagnostic accuracy for pediatric foreign body aspiration (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Aerodigestive foreign bodies present training challenges due to unstandardized treatment, intersection of multiple specialties (pediatric surgery, gastroenterology, ENT), and variable equipment familiarity. — David (opinion) [Ep 1 · 0:02](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2)
- Plain radiography for airway foreign bodies is neither sensitive nor specific; hyperinflation on decubitus films may indicate foreign body but can also be mucus plug or congenital stenosis. — David (clinical) [Ep 1 · 3:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=180)
- If clinical suspicion for airway foreign body is high, bronchoscopy is indicated even with normal or equivocal imaging. — David (clinical) [Ep 1 · 4:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=240)
- Flexible bronchoscopy via LMA is less invasive than rigid bronchoscopy and appropriate for low-suspicion cases; if foreign body is found, can convert to rigid instrumentation. — David (clinical) [Ep 1 · 5:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=300)
- The double-disc sign on AP radiograph (two concentric circles) is pathognomonic for button battery; lateral X-ray is not required for diagnosis. — David (clinical) [Ep 1 · 10:20](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=620)
- After button battery removal from esophagus, bronchoscopy should be performed to assess for tracheal erosion before assuming the airway is intact. — David (clinical) [Ep 1 · 13:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=780)
- Post-removal management of esophageal battery injury may include esophagography, NG tube placement, and surveillance endoscopy for stricture; steroids peri- and post-operatively may reduce airway swelling. — David (clinical) [Ep 1 · 14:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=840)
- Endovascular repair (stent) is the treatment for aorto-enteric fistula in pediatric patients; angiography is performed first to localize the fistula. — David (clinical) [Ep 1 · 17:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1020)
- Even if a battery reaches the stomach, esophageal evaluation (endoscopy or esophagography) may be warranted because transient esophageal lodgment can cause delayed perforation or fistula. — David (clinical) [Ep 1 · 20:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1200)
- Once a battery is in the stomach, it is electrically shorted out and poses less immediate risk than in the esophagus. — David (clinical) [Ep 1 · 22:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1320)
- Single magnet ingestions can be observed; the child should avoid MRI. — David (clinical) [Ep 1 · 28:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1680)
- Multiple magnets in the stomach that are clearly joined on X-ray can be observed with serial imaging to confirm they pass as a pair. — David (clinical) [Ep 1 · 28:40](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1720)
- Multiple magnets in different bowel segments (e.g., one in RUQ, one in LLQ) should be removed operatively due to risk of pressure necrosis and entero-enteric fistula. — David (clinical) [Ep 1 · 29:40](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1780)
- Magnets can cause gastro-splenic flexure colonic anastomosis or duodeno-mesenteric anastomosis by eroding through bowel walls. — David (clinical) [Ep 1 · 31:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1860)
- Foley catheter extraction of esophageal coins is performed under fluoroscopy: catheter is passed beyond the coin, balloon inflated with contrast, and coin flipped out. — David (clinical) [Ep 1 · 36:40](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2200)
- Foley extraction is generally limited to coins lodged <24 hours; if duration is unknown, endoscopic retrieval in OR is preferred. — David (clinical) [Ep 1 · 37:40](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2260)
- Sharp objects (e.g., safety pins) in the esophagus often flip in the stomach and pass with the sharp edge trailing; many can be observed rather than retrieved. — David (clinical) [Ep 1 · 42:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2520)
- Post-bronchoscopy tracheal tears with persistent air leak can be managed conservatively with chest tube, selective main-stem intubation past the tear, fibrin glue, or airway stent if leak persists beyond one week. — David (clinical) [Ep 1 · 43:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2580)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- There are tens of thousands of ED visits annually for foreign body ingestions; magnet injuries are on the rise, possibly peaking. — David summarizing the discussion [Ep 1 · 1:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=60)
- Peak age for foreign body ingestion is 2-3 years, due to distraction while eating, incomplete dentition, and poor swallowing coordination. — David summarizing the discussion [Ep 1 · 1:20](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=80)
- Virtual bronchoscopy by high-resolution CT is emerging for foreign body detection; it is quick but carries radiation exposure. — David summarizing the discussion [Ep 1 · 3:30](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=210)
- The 3-volt 20mm button battery is the key offender in esophageal injuries; higher voltage causes higher rates of electrochemical damage. — David summarizing the discussion [Ep 1 · 9:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=540)
- Esophageal tissue damage from button batteries begins within one hour; immediate retrieval is mandatory. — David summarizing the discussion [Ep 1 · 9:20](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=560)
- Aorto-esophageal fistula can occur days to weeks after button battery removal, presenting as sentinel bleed or sudden death; advanced imaging (MRI/CT) may be warranted in high-risk cases. — David summarizing the discussion [Ep 1 · 15:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=900)
- The negative (smaller disc) side of a button battery causes the necrosis; the outer disc with the plus sign is the positive terminal. — David summarizing the discussion [Ep 1 · 18:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1080)
- For button batteries that reach the stomach: AAP algorithm recommends endoscopic removal if diameter >2.5cm or length >6cm; smaller batteries can be observed. — David summarizing the discussion [Ep 1 · 19:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1140)
- There is a case report of a battery found in the stomach, observed, and the child later died of aorto-esophageal fistula from erosion at the lower esophageal sphincter. — David summarizing the discussion [Ep 1 · 23:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1380)
- Magnet ingestions have increased nine-fold in the last 10 years. — David summarizing the discussion [Ep 1 · 25:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1500)
- Thirty percent of coins lodged in the upper esophagus will pass spontaneously within 6-19 hours; 60% of coins in the lower esophagus will pass spontaneously. — David summarizing the discussion [Ep 1 · 33:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=1980)
- Milwaukee Children's Hospital reported 1200 cases of esophageal coin extraction over 20 years using Foley catheter in the ED by senior residents/fellows, with high success rate, no major complications, and 10-fold cost savings vs. OR. — David summarizing the discussion [Ep 1 · 35:00](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2100)
- Rare catastrophic complications of Foley extraction include esophageal or tracheal tear, massive hemoptysis, and need for ECMO. — David summarizing the discussion [Ep 1 · 38:40](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2320)
- Alabama and Indiana groups implemented level-1 trauma activation protocol for button battery ingestions, reducing door-to-OR time from 3 hours to 30 minutes. — David summarizing the discussion [Ep 1 · 40:20](https://origin-library.globalcastmd.com/watch/airway-and-esophageal-foreign-bodies-update-course-2015-875?t=2420)
- The systematic review and meta-analysis was conducted in Canada. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- The objective of the review was to evaluate the efficacy of computed tomography for the diagnosis of foreign body aspiration. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- The review identified 16 studies. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- The included studies contained 2,056 patients who had undergone CT for diagnosis of foreign body aspiration. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- The sensitivity of CT for diagnosing foreign body aspiration was 98.8%. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- The specificity of CT for diagnosing foreign body aspiration was 96.6%. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- CT appears to be very efficient for the diagnosis of foreign body aspiration. — Cecilia Gigena summarizing a resource [Ep 3 · 0:00](https://origin-library.globalcastmd.com/watch/una-revisi-n-sistem-tica-y-metan-lisis-de-la-tomograf-a-computarizada-en-el-diag-6972?t=0)
- A systematic review and meta-analysis was conducted in Canada to assess the diagnostic accuracy of CT for diagnosing foreign body aspirations. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)
- The review included 16 manuscripts. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)
- 2,056 patients underwent CT scan for the diagnosis of foreign body aspiration in the included studies. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)
- The sensitivity of CT for diagnosing foreign body aspiration was 98.8%. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)
- The specificity of CT for diagnosing foreign body aspiration was 96.6%. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)
- CT appears very accurate for the diagnosis of foreign body aspirations and could lead to avoiding unnecessary rigid bronchoscopy. — Cecilia Gigena summarizing a resource [Ep 2 · 0:00](https://origin-library.globalcastmd.com/watch/a-systematic-review-and-meta-analysis-of-computed-tomography-in-the-diagnosis-of-6971?t=0)

## Changelog
- Sep 25: 3 items added automatically

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