Introduction
Foreign body aspiration (FBA) is common at both extremes of age and is a
potentially life-threatening event(1). Advanced age, alcohol
intoxication, psychiatric illness, seizure disorders, stroke,
neuromuscular disorders, sedative or hypnotic drugs, and chronic
debilitating conditions predispose the elderly to FBA(2). Common foreign
bodies (FBs) aspirated include metallic objects, organic substances,
dentures, chicken or fish bones, and peas(3). FBA in the elderly poses a
diagnostic and therapeutic challenge due to several factors. These
include the masking of respiratory symptoms post-aspiration, atypical
imaging findings, the patient’s inability to recall the aspiration
event, and the challenges encountered during bronchoscopy(4). FBA
usually follows a choking event, often during feeding. The patient might
present with dyspnea, hemoptysis, cough, a fall in oxygen saturation,
anxiety, etc.(5). The signs and symptoms depend on the size of the
foreign body and the level of obstruction. Small objects lodged in
distal airways seldom produce acute symptoms, while the opposite is true
for larger FBs lodged in larger airways. Stridor is present if FBs are
lodged in trachea(6). FBA results in collapse/hyperinflation of lungs
aerated by the airway. If there is chronic obstruction, obstructive
pneumonia, bronchiectasis, and lung abscess can develop(2). FBs
generally lodge in the right middle and lower lobe bronchi(4). FBA
causing acute airway obstruction and respiratory failure requiring
urgent intervention.