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FOREIGN BODIES AND DAMAGE TO THE THROAT

Foreign bodies fall into the throat when breathing or when swallowing and are countless diverse objects. The outcomes of a foreign body staying in the pharynx are different: it can be coughed up, expelled with an exhalation, spit out, lie freely in the pharynx without injuring the mucous membrane, advance further and become a foreign body of the larynx, trachea and bronchi, the esophagus, finally, injure the mucous membrane and enter the soft tissue most often tonsils, pear-shaped sinuses, root of the tongue.

Small stitching foreign bodies, such as thin fish bones, often pierce the palatine tonsils, are visible with pharyngoscopy and are usually easily removed with forceps. It is more difficult to remove foreign bodies from the larynxopharynx using indirect laryngoscopy and laryngeal forceps, and if this fails, then direct laryngoscopy. If the foreign body is injuring, then emphysema and edema of the prevertebral cell space occur, then such a serious complication as mediastinitis can develop (Fig. 3.17). In addition, as a result of edema, an overhang of the posterior pharyngeal wall occurs, and it is difficult to examine the larynopharynx and manipulate in this area. As a rule, the above-described foreign bodies of the pharynx are safely removed, do not lead to death from acute asphyxia like foreign bodies of the larynx. The exception is large foreign bodies that get stuck during the act of swallowing in the oropharynx, because they cannot slip into the esophagus from the epiglottis, which closes the entrance to the larynx at that time. If such a foreign body, the patient can not expectorate with a strong exhalation or vomiting, loss of consciousness and death may occur.



Damage to the pharynx. Wounds of the pharynx distinguish between internal and external. Internal damage is usually associated with foreign bodies or random objects (more often in children).
The tactics of treatment are elimination of a foreign body (see the corresponding section), anti-inflammatory therapy, and a sparing diet. External damage to the pharynx occurs with cut, puncture or gunshot wounds of the face and neck and is characterized by a variety of symptoms and severity depending on the location of the wound and the course of the wound channel, which determine damage to other organs of the neck, large vessels, and spine. In the diagnosis of pharyngeal injuries, in addition to pharyngoscopy, external examination, radiography is of great importance for - for determining foreign bodies (bullet, fragment, cold weapon fragment) and spinal damage. Among the first therapeutic measures, first of all, is a stop of bleeding. Here, nasopharyngeal tamponade can be successfully applied in case of bleeding from it, or tamponade through the wound canal, such as when the jugular vein is wounded - between the lower jaw and the styloid process (according to K.L. Khilov). If necessary, produce ligation of the great vessels - the external and even common carotid artery.

Another vital issue is ensuring respiratory function, which can be impaired by the wound itself and its consequences (hematoma, edema, inflammation. Decongestant therapy can be used here, and if necessary, tracheotomy.

After hemostasis and respiratory recovery, it is necessary to treat the wounds of the neck, to remove the damaging accessible foreign bodies. The patient’s nutrition should also be provided by a doctor, since most often with such injuries, a probe must be inserted into the esophagus to prevent food and fluid from entering the wound channels for 1 to 2 weeks.
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FOREIGN BODIES AND DAMAGE TO THE THROAT

  1. Foreign bodies of the pharynx
    Foreign bodies of the pharynx often come with food (fish and meat bones, glass fragments, pieces of wire, pieces of meat, lard). Foreign bodies can also be objects that accidentally fall into the mouth (pins, nails, buttons), dentures. Less common are living foreign bodies (leeches, roundworms). The ingestion of foreign bodies in the throat can be caused by such predisposing moments as fast food,
  2. Foreign bodies of the pharynx
    Foreign bodies of the pharynx are quite common. They can be of various nature and shape: fish bones, metal objects (nails, pins), pieces of wood, shells of cereals, pieces of fruit, etc. Often in the throat pieces of unhealed food get stuck, dentures, etc. The reasons for the ingestion of foreign bodies in the throat are inattentive food intake, conversation, laughter with food. Children left
  3. Foreign bodies in the throat and esophagus
    Sometimes not only kittens, but also excessively curious adult cats swallow foreign objects. Some of these items are so small that they easily slip through the throat and esophagus, and then safely pass the stomach and intestines, and go out naturally, while others can get stuck. Often, for example, fish bones are stuck between the teeth, or stuck in the back of the throat
  4. FOREIGN BODIES IN THE FIELD OF THE MOUTH, THROAT, AND ESOPHAGUS
    The reasons for the entry of foreign bodies into the esophagus in dogs may be the habit of playing various objects and, hasty food, accidentally swallowing toys. In cats, the cause of foreign bodies (most often these are sewing needles with or without thread) is the special structure of the villi of the tongue. When trying to free itself from a randomly captured foreign body, a cat pushes it with tongue movements
  5. Foreign bodies in the mouth, pharynx, larynx, trachea, esophagus, stomach and intestines
    Foreign bodies can be sharp, damaging and obstructing (clogging) the pharynx, larynx and esophagus. In case of suffocation, an urgent tracheotomy is necessary. The dog is fixed in the dorsal position, the hair is quickly removed from the ventral surface of the anterior third of the neck, twice the skin is lubricated with a 3% alcohol solution of iodine. Through a needle inserted strictly along the midline of the ventral surface
  6. Damage and foreign bodies of the esophagus
    Damage to the esophagus is external and internal. External, rarer ones include a breakthrough in the esophagus of abscesses of the lymph nodes, a tumor growing in it. Military injuries and incised wounds of the esophagus are possible in combination with damage to the pharynx and trachea. Internal damage - all cases of damage to the mucous membrane or the entire wall of the esophagus by foreign bodies, chemical agents,
  7. Foreign bodies
    Foreign bodies of the ear, nose, pharynx, and less commonly, the larynx, trachea, and bronchi, are more common. Foreign bodies of the ear are more common in children (paper, pencils, fruit bones), in adults - foreign bodies with sharp edges (fragments of matches) and insects. Rinsing with water is contraindicated during perforation of the tympanic membrane and complete obstruction of the lumen by a foreign body. Insects are killed before removal,
  8. Alien bodies of the digestive tract
    Foreign bodies of the pharynx Foreign bodies almost always enter the pharynx with food. Hasty food, lack of teeth, diseases of the masticatory apparatus, sudden cough, laughter, talking with food contributes to their ingestion. In addition, foreign bodies can enter the pharynx through the nose, as well as from the larynx and esophagus. Of particular danger are large foreign bodies. They are stuck in the larynx.
  9. Foreign bodies
    Foreign bodies in the throat Cause Foreign bodies often fall into the throat with food. It can be fish and meat bones, glass fragments, pieces of plastic, large pieces of food. Foreign objects can also get into the mouth - pins, nails, buttons, dentures. Foreign bodies enter the mouth as a result of rapid absorption of food, sudden laughter or coughing during meals, and
  10. Foreign bodies in the airways
    When a foreign body enters the respiratory tract of a child, a cough immediately appears, which is an effective means of removing a foreign body, an attempt to stimulate it is a first aid. In the absence of cough and its inefficiency with complete obstruction of the respiratory tract, asphyxia quickly develops and urgent measures are needed to evacuate a foreign body. DIAGNOSTICS Basic
  11. Foreign bodies of the larynx
    Meat and fish bones, needles, pins, buttons, eggshells, dentures, coins, small parts of toys usually enter the larynx from the mouth, less often from the stomach when vomiting. Such foreign bodies are much less common, such as parts of broken surgical instruments, tissue removed during surgery (adenoids, palatine tonsil, polyp), as well as living foreign bodies (leeches, roundworms,
  12. FOREIGN BODIES OF THE EAR
    Foreign bodies in the external auditory canal are more common in children who, during games, put various small objects (buttons, beads, seeds, small bones, balls, pebbles, peas, beans, paper, parts from toys, grains, etc. into their ears. ) In adults, foreign bodies may have fragments of matches, pencil rods, pieces of cotton, stuck in the ear canal at the time of the toilet
  13. Foreign bodies of the nose
    Clinical picture Foreign bodies of the nose are more common in children who, during the game, insert various small objects into their nose (beads, buttons, sunflower seeds, peas, berry seeds, coins, pieces of paper, etc.). Foreign bodies can get into the nose during combat and industrial injuries of the face (shell splinters, bullets, pieces of glass, stones, molten metal), as well as with vomiting
  14. Foreign bodies of the larynx
    Foreign bodies of the larynx, trachea and bronchi are more common in children. They enter the respiratory tract if the child inadvertently eats and adults do not control the behavior of children. Among foreign bodies, sunflower seeds, watermelon, pumpkin, pieces of carrots, coins, pins, parts of fountain pens, toys, etc. are more common. In adults, foreign bodies enter the respiratory tract with careless and inattentive
  15. Foreign bodies of the larynx
    Objects that can be foreign bodies of the larynx are very diverse - from a fallen tooth and food items to small metal objects. They can lie freely or penetrate the soft tissue of the larynx. There are differences in the clinic of foreign bodies depending on their location. Foreign bodies of the upper floor of the larynx, including the vestibular folds and organisms of the ventricle, mainly result
  16. ASPIRATION OF A FOREIGN BODY
    Definition Foreign body aspirated into the respiratory tract. Etiology Foreign body aspirated by a child. Entry into the trachea of ​​teeth displaced during manipulations in the upper respiratory tract. Surgical material remaining in the respiratory tract after surgery. Typical cases In children aged 7 months to 4 years: foreign body aspiration
  17. Foreign bodies of the esophagus
    The ingress of foreign bodies into the esophagus is random and the predisposing moments are considered in the description of the physiology of the esophagus. Foreign bodies linger in places of physiological constriction, most often (50 - 60%) - in the area of ​​cricopharyngeal constriction, which has powerful striated muscles. The second place in the frequency of fixation of foreign bodies is in the thoracic region -
  18. Foreign bodies of the outer ear
    Clinical picture Foreign bodies of the outer ear are most often observed in children who, playing with various small objects (pebbles, cherry stones, beads, buttons, sunflower seeds, peas, paper balls, etc.), put them into their ears. In adults, foreign bodies can be matches, pieces of cotton wool. There are also living foreign bodies (insects). Symptoms depend on the magnitude.
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