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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The author illustrated numerous cases with X-ray pictures in which diagnosis was either missed and/or treatment delayed before first seen by him.
