er intrusion, and others may persist for a
time after the passage, removal, or expulsion of a foreign body.

ESOPHAGEAL FOREIGN BODY SYMPTOMS

1. There are no absolutely diagnostic symptoms.
2. Dysphagia, however, is the most constant complaint, varying with
the size of the foreign body, and the degree of inflammatory or
spasmodic reaction produced.
3. Pain may be caused by penetration of a sharp foreign body, by
inflammation secondary thereto, by impaction of a large object, or by
spasmodic closure of the hiatus esophageus.
4. The subjective sensation of foreign body is usually present, but
cannot be relied upon as assuring the presence of a foreign body for
this sensation often remains for a time after the passage onward of
the intruder.
5. All of these symptoms may exist, often in the most intense
degree, as the result of previous violent attempts at removal; and the
foreign body may or may not be present.

SYMPTOMS OF LARYNGEAL FOREIGN BODY

1. Initial laryngeal spasm followed by wheezing respiration, croupy
cough, and varying degrees of impairment of phonation.
2. Pain may be a symptom. If so, it is usually located in the
laryngeal region, though in some cases it is referred to the ears.
3. The larynx may tolerate a thin, flat, foreign body for a
relatively long period of time, a month or more; but the development
of increasing dyspnea renders early removal imperative in the majority
of cases.

SYMPTOMS OF TRACHEAL AND BRONCHIAL FOREIGN BODY

1. Tracheal foreign bodies are usually movable and their movements
can usually be felt by the patient.
2. Cough is usually present at once, may disappear for a time and
recur, or may be continuous, and may be so violent as to induce
vomiting. In recent cases fixed foreign bodies cause little cough;
shifting foreign bodies cause violent coughing.
3. Sudden shutting off of the expiratory blast and the phonation
during paroxysmal cough is almost pathognomonic of a movable tracheal
foreign body.
4. Dyspnea is usually present in tracheal foreign bodies, and is due
to the bulk of the foreign body plus the subglottic swelling caused by
the traumatism of the shiftings of the intruder.
5. Dyspnea is usually absent in bronchial foreign bodies.
6. The respiratory rate is increased only if a considerable portion
of lung is out of function, by the obstruction of a main bronchus, or
if inflammatory sequelae are extensive.
7. The asthmatoid wheeze is