Foreign Bodies of the Air and Food Passages

The author presents a statistical analysis of foreign bodies in the air and food passages based on the data obtained from 37 medical school hospitals throughout Japan.<br>Of 7371 total number of cases 1571 (20.3%) were of foreign bodies of the respiratory tract and 5800 (79.7%) were of the food passage; the latter constitutes 3.6 times of the former.<br>Sex: Of the total number, 4365 (59.3%) were males and 3006 (40.7%) were females: the ratio between two sexes is 3 to 2. In the foreign bodies of the air passage males accounted 891 and females 650, and in the food passage 3444 and 2356 respectively.<br>Age: In my experience the youngest patient was one month old and the oldest, 85 years of age. In the foreign bodies of the respiratory tract, 1104 (75.1%) were under 15 years old and in those of food passage 2659 (45.8%) were under 15 years old.<br>Kind of foreign bodies in the air passage : Of 1557 known intruders 505 (33.7%) were peanuts and beans, 122 (7.9%) were pins of various kinds, 73 (4.7%) were toys, 71 (4.5%) were pencilcaps, 51 (3.2%) were nails and 725 (45.6%) constituted various other objects.<br>Kind of foreign bodies in the food passage: Of 5388 known intruders 1588 (29.8%) were bones mostly of fish, 2002 (37.1%) were coins, 269 (5.0%) were food particles, 394 (7.3%) were dentures, 168 (3.1%) were toys and 967 (17.9%) were various other objects.<br>Place of lodgement: In the respiratory tract 285 (22.1%) were found in the nasal cavity, 212 (16.4%) in the larynx, 291 (22.6%) in the trachea and 497 (39.6%) in the bronchi. In the food passage 959 (18.5%) were in the pharynx, 2701 (51.8%) in the upper esophageal region, 687 (11.1%) in the midesophagus, and 154 (2.9%) in the loweresophagus and 653 (12.5%) were in the stomach.<br>Diagnosis: Of 789 foreign bodies in the air passage in which an accurate date were available 562 (72.5%) were diagnosed accurately and promptly; and of 3006 foreign bodies of the food passage 2649 (88.2%) were similary diagnosed.<br>Endoscopic removal: Of 984 foreign bodies in the air passage 786 (70.7%) were removed at the first endoscopic examination, 139 (14.1%) require two or three times and 104 (10.4%) required more than four endoscopies.<br>Of 3037 foreign bodies in the food passage 2631 (86.6%) were removed at the first endoscopic examination. 141 (4.7%) required two and 113 (3.3%) required three examinations. 152 (5.0%) were expelled spontaneously.<br>Death: Of 1239 foreign bodies in the air passage there were 60 (4.8%) deaths, and of 5455 foreign bodies of the food passage there were 55 (1.0%) deaths.<br>The author illustrated numerous cases with X-ray pictures in which diagnosis was either missed and/or treatment delayed before first seen by him.