Management of an unusual presentation of foreign body aspiration

1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh
Keyword(s):  
Foreign Body ◽  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Foreign Body Aspiration ◽  
Positive Pressure ◽  
Review Of The Literature ◽  
X Ray ◽  
Post Surgery ◽  
Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

FOREIGN BODY ASPIRATION IN CHILDREN: RADIOLOGICAL EVALUATION OF PREOPERATIVE CHEST X-RAY

2021 ◽  
Vol 24 (04) ◽  
Author(s):  
Rasha Nadeem Ahmed ◽  
Bassam Khaleel Al-abbasi ◽  
Nashwan M-Al Hafidh
Keyword(s):  
Foreign Body ◽  
Foreign Body Aspiration ◽  
Radiological Evaluation ◽  
X Ray ◽  
Chest X Ray ◽  
Preoperative Chest

scholarly journals A gyermekkori alsó légúti idegentest-aspiráció diagnosztikája a klinikai gyakorlatban

2018 ◽  
Vol 159 (51) ◽  
pp. 2162-2166
Author(s):  
Dániel Hajnal ◽  
Tamás Kovács
Keyword(s):  
Foreign Body ◽  
Standard Procedure ◽  
False Negative ◽  
Radiological Finding ◽  
Paediatric Population ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
X Ray ◽  
Co Morbidity ◽  
Chest X Ray

Abstract: Introduction and aim: Rigid bronchoscopic foreign body removal is the gold standard procedure for foreign body aspiration. We have analysed our results of bronchoscopies and the accuracy of diagnosis among the paediatric population in Southeast Hungary. Method: A retrospective study of children admitted because of suspected solid foreign body aspiration between 2006 and 2017 was performed. Results: From among 220 admitted patients, 86 were suspected of solid particle aspiration. Presenting history was certain in 68.6% (n = 59/86). Sudden choking-like symptoms were present in 61/86 patients (70.9%), coughing in 81/86 patients (94.2%). Thoracic auscultation was positive in 67/86 cases (77.9%), chest X-ray in 75/86 patients (87.2%), while fluoroscopy only in 12/75 cases (16%). 92 bronchoscopies in 86 patients were performed. In 57 bronchoscopies, solid foreign body was found (66.2%) and the removal was successful in 56 cases. Thoracic auscultation was negative in patients with foreign body only in 6/57 cases (10.5%). In the same group, chest X-ray was negative in 33/57 cases (57.9%) and fluoroscopy was positive only in 12/57 patients (21.1%). Pneumonia or prolonged bronchitis was present in 4/86 patients (4.6%). Severe bronchial bleeding occurred in 2/86 cases (2.3%). Mortality was 1.2%, a child with severe co-morbidity and chronic aspiration passed away. Bronchoscopy was negative in 29/86 patients (33.7%). Complications were significantly higher in chronic cases than in the acute ones. Conclusion: Rigid bronchoscopy is indicated if solid foreign body aspiration is suspected and positive anamnesis, typical symptoms (coughing, choking) or positive chest auscultations are present. Diagnosis predominantly based on radiological finding is controversial due to the high possibility of false negative results. Early intervention within the first 24 hours is recommended to avoid complications. Orv Hetil. 2018; 159(51): 2162–2166.

scholarly journals Bronchial Leech Infestation in a 15-Year-Old Female

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Mohammad Ashkan Moslehi ◽  
Mohammad Hadi Imanieh ◽  
Ali Adib
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Young Children ◽  
Lower Lobe ◽  
Foreign Body Aspiration ◽  
Ground Glass ◽  
Chest Computed Tomography ◽  
X Ray ◽  
Chest X Ray ◽  
The Right

Foreign body aspiration (FBA) is a common incidence in young children. Leeches are rarely reported as FBA at any age. This study describes a 15-year-old female who presented with hemoptysis, hematemesis, coughs, melena, and anemia seven months prior to admission. Chest X-ray showed a round hyperdensity in the right lower lobe. A chest computed tomography (CT) demonstrated an area of consolidation and surrounding ground glass opacities in the right lower lobe. Hematological investigations revealed anemia. Finally, bronchoscopy was performed and a 5 cm leech was found within the rightB7-8bronchus and removed by forceps and a Dormia basket.

scholarly journals Ekstraksi Benda Asing pada Kavum Nasi Melalui Bronkoskopi

2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya
Keyword(s):  
Foreign Body ◽  
Nasal Cavity ◽  
Upper Airway ◽  
The United States ◽  
Foreign Body Aspiration ◽  
Lower Airway ◽  
X Ray ◽  
Tracheobronchial Foreign Body ◽  
Chest X Ray ◽  
The Right

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.

scholarly journals Cervicofacial Surgical Emphysema following Tonsillectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Samir Yelnoorkar ◽  
Wolfgang Issing
Keyword(s):  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
X Ray ◽  
Swallowing Difficulties ◽  
Considerable Length ◽  
Surgical Emphysema ◽  
The Right

We report the case of a patient who developed cervicofacial subcutaneous emphysema following a routine tonsillectomy. An 18-year-old male with swallowing difficulties underwent a tonsillectomy and developed swelling of the right side of his neck and face 36 hours after surgery. A neck X-ray revealed subcutaneous emphysema. Unlike similar previously published cases, there were no postoperative issues of coughing, straining, or use of positive pressure ventilation. The complication also occurred after a considerable length of time. Further complications may include pneumothorax and pneumomediastinum and these should be excluded.

scholarly journals Unilateral Pulmonary Aplasia: A Case Report

2010 ◽  
Vol 30 (2) ◽  
pp. 116-118 ◽  
Author(s):  
Prabina Shrestha ◽  
Prakash Poudel ◽  
Panna Lal Sah
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Congenital Abnormalities ◽  
Rare Condition ◽  
Foreign Body Aspiration ◽  
Pulmonary Agenesis ◽  
X Ray ◽  
Mediastinal Shift ◽  
Chest X Ray ◽  
Mass Lesions

Chest X-Ray findings of unilateral lung or lobar collapse with a shift of mediastinal shift towards the affectedside may prompt differential diagnoses of suspected foreign body aspiration, mucus plug occlusion, andbronchial mass lesions. We must also consider the rare condition of pulmonary agenesis. It is one of therare congenital abnormalities in the development of the lungs in which there is complete absence of alung. We report a three month old child with right sided pulmonary aplasia.Key words: Agenesis lung; pulmonary aplasia; congenital abnormalityDOI: 10.3126/jnps.v30i2.2645J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 116-118

scholarly journals UTILITY OF CLINICAL AND RADIOLOGICAL SIGNS IN AIRWAY FOREIGNBODIES

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Deepchand . ◽  
Pooja D Nayak ◽  
Vivek Samor ◽  
Ramchandra Bishnoi
Keyword(s):  
Foreign Body ◽  
Physical Examination ◽  
Chest Radiograph ◽  
Gold Standard ◽  
Foreign Body Aspiration ◽  
X Ray ◽  
History Of ◽  
Chest X Ray ◽  
Grave Problem ◽  
Delays In Diagnosis

Background: Foreign Body Aspiration (FBA) is a grave problem in children and delays in diagnosis and management can be devastating. The history is very often vague, with subtle physical and chest radiograph abnormalities Aim: To assess the diagnostic accuracy of the triad: history of chocking, unilateral reduction in air entry to lungs, unilateral hyperinflation or collapse on chest X-ray. Results: In our study sensitivity of history of chocking in detection of FB was 80.47%, specificity was 20.45%. Sensitivity of examination finding of unilateral decrease in air entry to lungs in detection of FB was 71.59%%, specificity was 4.545%.  Sensitivity and specificity of chest radiograph in detection of FB was 54.43% and 47.72% respectively. When the triad of history of chocking, decreased air entry on examination and chest radiograph finding of hyperinflation or collapse was considered in detection of FB in airway sensitivity was 59.76% while specificity was 79.54%. Conclusion: Bronchoscopy is a gold standard in diagnosis of FBA. History, physical examination and radiologic studies have a very low specificity in detection of FBA. The triad of history of chocking, decreased air entry on examination and chest radiograph finding of hyperinflation or collapse has a better specificity in detection of FBA than individual parameters.

scholarly journals Improving lung aeration in ventilated newborn preterm rabbits with a partially aerated lung

2020 ◽  
Vol 129 (4) ◽  
pp. 891-900
Author(s):  
Emily J. Pryor ◽  
Marcus J. Kitchen ◽  
Michelle K. Croughan ◽  
Kelly J. Crossley ◽  
Megan J. Wallace ◽  
...  
Keyword(s):  
Phase Contrast ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Lung Mechanics ◽  
Positive Pressure ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Optimal Approach ◽  
Preterm Newborns

Preterm newborns commonly receive intermittent positive pressure ventilation (iPPV) at birth, but the optimal approach that facilitates uniform lung aeration is unknown, particularly in a partially aerated lung. Using phase contrast X-ray imaging, we showed that combining a long inflation time (1.0 s) with surfactant improved lung mechanics and aeration in the immediate newborn period. The current clinical practice of using short inflation times during iPPV might be suboptimal, and a different approach is needed.

Foreign Body in the Airway

2018 ◽  
Author(s):  
Vidya Chidambaran ◽  
Senthilkumar Sadhasivam
Keyword(s):  
Foreign Body ◽  
Anesthetic Management ◽  
Foreign Body Aspiration ◽  
Spontaneous Ventilation ◽  
X Ray ◽  
Airway Edema ◽  
Temporary Relief ◽  
Life Saving ◽  
Chest X Ray ◽  
Rule Out

Anesthetic management of suspected foreign body aspiration in the airway can be challenging. It is critical to develop a coordinated plan with the surgeon. Removal of a foreign body may necessitate laryngoscopy, bronchoscopy (commonly used), thoracoscopy, thoracotomy, or even a tracheotomy. Anesthesia could be induced using inhalation or intravenous anesthetics, while maintaining spontaneous ventilation. However, there is no consensus as to whether controlled or spontaneous ventilation is more advantageous. Maintaining deep planes of anesthesia, with minimal airway reflexes, during bronchoscopy is essential. In the event that total airway obstruction due to a tracheal foreign body occurs, a potentially life-saving technique is to push the object deeper into one of the main bronchi, for temporary relief. Postoperatively, steroids, racemic epinephrine, and intubation/ventilation may be necessary for airway edema. A chest x-ray may be indicated to rule out postobstructive pulmonary edema, pneumothorax, and pneumonia.

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