Pitfalls in the diagnosis of aerodigestive tract foreign bodies.

In the young child, particularly those between the ages of 1 and 3 years, aerodigestive tract foreign bodies continue to be a significant problem. Early diagnosis and treatment can decrease morbidity and length of hospital stay in these children. Three cases of delayed diagnosis in children with bronchial (2) and esophageal (1) foreign bodies are presented. In dealing with young children it is important to maintain a high clinical suspicion of a foreign body and to perform a detailed history and physical examination. Options in radiographic analysis of the patient with a suspected foreign body, probable locations of the foreign body, and the likelihood of definitive radiographic findings are discussed. Importantly, a negative radiographic analysis does not rule out the presence of an aerodigestive tract foreign body. Two flow charts for the evaluation of patients who have possibly ingested or inhaled a foreign body are presented to aid the primary care physician in diagnosis.