scholarly journals A Five-Year Review on Pediatric Foreign Body Aspiration

2020 ◽  
Author(s):  
Zuraini Mohammad Nasir ◽  
Sethu Thakachy Subha
Keyword(s):  
Foreign Body ◽  
Hospital Stay ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Foreign Body Aspiration ◽  
Flexible Bronchoscope ◽  
Delayed Treatment ◽  
Younger Age

Abstract Introduction Foreign body aspiration is a leading cause of accidental death in children. Clinical presentation varies from non-specific respiratory symptoms to respiratory failure making diagnosis challenging. Objective To review pediatric patients who underwent bronchoscopy due to suspicion of foreign body aspiration at a tertiary center in Malaysia. Methods We retrospectively studied patients < 11 years old who underwent bronchoscopy from 2008 to 2018. Results Over the 10-year period, 20 patients underwent bronchoscopy, and 16 were found to have foreign body aspiration with equal gender distribution. The most common age group was < 3 years old (75%). The most common clinical presentations were choking (82%) and stridor (31%). Foreign bodies were removed using flexible bronchoscope in 8 cases (50%), and difficulties were encountered in 6 cases (75%). Rigid ventilating bronchoscope was used in 8 cases (50%) with no difficulty. The most common object found was peanut (19%). The majority of foreign bodies were lodged in the right bronchus (43%). Eight patients (80%) received delayed treatment due to delayed diagnosis. The length of hospital stay was longer in the younger age groups. Conclusion Clinical presentation and chest radiograph findings were comparable across all age groups. The most difficulties encountered during foreign body removal were via flexible bronchoscope, in children < 3 years old. There was no significant correlation between age and type of foreign body aspiration. The majority of patients who received delayed treatment were < 3 years old. The length of hospital stay was longer in the younger age groups.

scholarly journals Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 69-74
Author(s):  
Danijela Dragicevic ◽  
Ljiljana Jovancevic ◽  
Rajko Jovic ◽  
Ljiljana Vlaski ◽  
Bojan Bozic
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Age Groups ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Radiological Findings ◽  
Tracheobronchial Foreign Body ◽  
The Moment ◽  
The Right

Introduction. Foreign body aspiration into the respiratory tract remains a diagnostic and therapeutic challenge in clinical practice, especially in young children, who are the most frequently affected age group. The aim of this study was to present the results of treating the patients with foreign body aspiration in all age groups. Material and Methods. The medical and radiological records of 64 patients with confirmed foreign body out of 146 patients with suspected foreign body aspiration were retrospectively analyzed during the period of 13 years (from 2001 to 2013). Results. A foreign body was found in 64 (44%) of the 146 patients of all age groups with suspected foreign body aspiration. The patients? age ranged between 11 months and 80 years. There were 84% children and 16% adults, and 63% of patients were male. Time between the moment of aspiration and admission to the Department ranged between 0.5 hours and 14 days, with majority of patients (70%) being admitted during the first 24 hour. History of respiratory drama was present in 92% of patients. Physical and radiological findings were positive in 66% and 47% of patients, rescpectively. Organic vegetable foreign bodies accounted for 75% of all cases, and they were most frequently found in the right main bronchus (63%). All foreign bodies were successfully extracted by rigid bronchoscopy, without serious complications and fatal outcomes. Conclusion. Bronchoscopy should be performed in any case of suspected foreign body aspiration, even if clinical and radiological findings are normal, in order to avoid serious and possible life-threatening complications. More should be done to raise awareness of this potentially preventable condition.

Foreign body aspiration and language spoken at home: 10-year review

2011 ◽  
Vol 125 (7) ◽  
pp. 719-723 ◽  
Author(s):  
S Choroomi ◽  
J Curotta
Keyword(s):  
Foreign Body ◽  
Hospital Stay ◽  
Foreign Bodies ◽  
Retrospective Chart Review ◽  
Foreign Body Aspiration ◽  
Body Type ◽  
Paediatric Hospital ◽  
English Speaking ◽  
Language Spoken At Home ◽  
At Home

AbstractObjective:To review foreign body aspiration cases encountered over a 10-year period in a tertiary paediatric hospital, and to assess correlation between foreign body type and language spoken at home.Study design and method:Retrospective chart review of all children undergoing direct laryngobronchoscopy for foreign body aspiration over a 10-year period. Age, sex, foreign body type, complications, hospital stay and home language were analysed.Results:At direct laryngobronchoscopy, 132 children had foreign body aspiration (male:female ratio 1.31:1; mean age 32 months (2.67 years)). Mean hospital stay was 2.0 days. Foreign bodies most commonly comprised food matter (53/132; 40.1 per cent), followed by non-food matter (44/132; 33.33 per cent), a negative endoscopy (11/132; 8.33 per cent) and unknown composition (24/132; 18.2 per cent). Most parents spoke English (92/132, 69.7 per cent; vs non-English-speaking 40/132, 30.3 per cent), but non-English-speaking patients had disproportionately more food foreign bodies, and significantly more nut aspirations (p = 0.0065). Results constitute level 2b evidence.Conclusion:Patients from non-English speaking backgrounds had a significantly higher incidence of food (particularly nut) aspiration. Awareness-raising and public education is needed in relevant communities to prevent certain foods, particularly nuts, being given to children too young to chew and swallow them adequately.

scholarly journals Gastrointestinal Perforation by Ingested Foreign Bodies: Experience at A Surgical Department in Tunisia

2021 ◽  
Author(s):  
Atef MEJRI ◽  
Emna Trigui ◽  
sarra saad ◽  
jasser yaacoubi ◽  
skander mrad ◽  
...  
Keyword(s):  
Foreign Body ◽  
Hospital Stay ◽  
Foreign Bodies ◽  
Length Of Hospital Stay ◽  
Gastrointestinal Perforation ◽  
Duration Of Symptoms ◽  
Female Ratio ◽  
Surgical Department ◽  
Low Middle Income Countries ◽  
The Mean

Abstract Background Management of gastrointestinal perforation by ingested foreign bodies remains a topical subject following technological progress. This work aims to analyze, the epidemiological features, the management in a Tunisian surgical department and to access the most realistic and beneficial management of gastrointestinal perforation by ingested foreign bodies in a low-income country, where there is a paucity of information regarding this subject Methods This is a retrospective review of 24 patients with gastrointestinal perforation by ingested foreign bodies treated in the General Surgery department of Jendouba Hospital in Tunisia from January 2010 to December 2019. Results 24 patients with gastrointestinal tract perforation by an ingested foreign body were managed at our surgical ward. The mean age of patients was 56.58 years with extreme ranging 25-72 years with a male to female ratio 2/1. Three patients (12.5%) had psychiatric disorder, one had myasthenia (4.1%), two patients were alcoholics (8.33%), three patients were toothless (12.5%) and two (8.33%) patients were veiled. According to ASA classification, 6 (25%) patients were ASA I, 15 (62.5%) patients ASA II, 3 (12.5%) ASA III. The mean duration of symptoms was 2.16 days and ranges from 1 to 7 days. All patients (100%) presented to the emergency department with acute abdominal pain. Sixteen patients (66.66%) had a fever, twelve (50%) had vomiting and four (16.66%) had a sub-occlusive syndrome. All patients had performed abdominal x-ray. The foreign bodies were objectified in only six cases (25%). CT scan was performed in 16 (66.66%) patients and the location of ingested foreign bodies was obtained in 9 patients preoperatively (37.5%) and in 4 patients (16.66%) after proofreading. All the 24 patients underwent surgery and they were operated during their initial hospital stay. The most common site of perforation was the terminal ileum (62,5%) followed by the duodenum (12, 5%). Enterectomy was the procedure of choice in 20 patients (16 underwent an enterostomy and 4 patients underwent an enteroanastomosis) and four patients had a simple suture. The foreign body was found in all patients. Two patients developed postoperative complications: one case of intraabdominal abscess and one patient had a wound dehiscence . The median length of hospital stay following surgery was 4.08 days (range 2-7 days). The mortality rate was 4.16 %. All patients managed with enterostomy, had their stoma closed after 3-5 months. Conclusion Open Surgery still remains a management with satisfactory morbidity, mortality and length of hospital stay. However, we estimate that for low/middle-income countries, investing in laparoscopy, for these cases, would be more realistic and more beneficial allowing improving more the outcomes. For this fact, promoting radiologic diagnosis is highly recommended in order to increase prospective identification of the foreign body location and perforation site, allowing a safe laparoscopic approach.

Respiratory disease in foreign body aspiration in children

1927 ◽  
Vol 23 (11) ◽  
pp. 1145-1150
Author(s):  
G. M. Lopatin
Keyword(s):  
Foreign Body ◽  
Respiratory Tract ◽  
Respiratory Disease ◽  
Foreign Bodies ◽  
Foreign Body Aspiration ◽  
The Body ◽  
Different Parts

Aspiration of foreign bodies into the windpipe usually results in respiratory damage. This lesion may be of varying intensity and may be localized in different parts of the respiratory tract or lungs. Both the intensity and the localization of the lesion may depend on a number of reasons and above all on the location of the foreign body and its type, but also on the constitutional characteristics of the body and on many other causes. Aspirated foreign bodies are found in the trachea or larynx and almost as often in the bronchi.

scholarly journals Occult Liver Abscess Following Clinically Unsuspected Ingestion of Foreign Bodies

1997 ◽  
Vol 11 (5) ◽  
pp. 445-448 ◽  
Author(s):  
Ban CH Tsui ◽  
J Mossey
Keyword(s):  
Foreign Body ◽  
Preoperative Diagnosis ◽  
Foreign Bodies ◽  
Clinical Presentation ◽  
Computed Tomographic ◽  
Liver Abscesses ◽  
Computed Tomographic Scan ◽  
History Of ◽  
Variable Clinical Presentation

Two uncommon cases of foreign body (a wooden clothespin and a toothpick) perforation of the gut with associated pyogenic liver abscesses are presented. These cases illustrate the difficulties of preoperative diagnosis. The lack of history of ingestion of foreign bodies, variable clinical presentation of the conditions and radiolucent natures of the foreign bodies all play a role in impeding the diagnosis preoperatively. This report emphasizes the role of ultrasound and computed tomographic scan in evaluating similar cases. Any patient with known risk factors for ingestion of foreign body should arouse suspicion and be investigated further.

scholarly journals Foreign Body Aspiration in Infants and Older Children: A Comparative Study

2019 ◽  
Vol 99 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Shorook Na’ara ◽  
Igor Vainer ◽  
Moran Amit ◽  
Arie Gordin
Keyword(s):  
Foreign Body ◽  
Medical Center ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Foreign Body Aspiration ◽  
Preschool Age ◽  
Small Airways ◽  
Older Children ◽  
X Ray ◽  
Young Infants

Background: Foreign body aspiration (FBA) is a major cause of morbidity and mortality in children. It is a preventable event that predominates in preschool age. The signs and symptoms mimic respiratory diseases common in the same age-group. We compared FBA in infants to FBA in older children. Methods: Retrospective analysis of all the cases of suspected FBA of children under the age of 18 years hospitalized at one medical center during 2002 to 2016. We analyzed the data according to age: up to 1 year (infants) and 1 to 18 years. Results: One hundred seventy-five children with suspected FBA were admitted; of whom, 27 (15%) were infants and 148 (85%) were older children (age 1-18 years). For the 2 age groups, adults witnessed 85% and 73%, respectively, of the incidents ( P = .4). In the neonate group, 48% presented with normal X-ray findings compared to only 20% in the older group; 15% of the older group had a positive chest X-ray for a foreign body, while none had such in the infants’ group ( P = .01). For the 2 age groups, the majority of the FBs found were from organic origin. About half of the patients were diagnosed and managed within 24 hours of the aspiration event. In 10%, repeated bronchoscopy was performed due to a retained FB remnant. In a multivariate analysis, signs and symptoms ( P < .05), location of the FB ( P < .001), and witnessed aspiration ( P < .001) were independent prognostic factors for the length of hospitalization. Conclusion: Foreign body aspiration is not uncommon in young infants; the management is challenging due to small airways, the need to use smaller bronchoscopes, and the lack of working channel forces in pediatric bronchoscopes.

scholarly journals Factors associated with the length of hospital stay of women undergoing cesarean section

2019 ◽  
Vol 53 ◽  
pp. 65
Author(s):  
Samire Lopes Pereira ◽  
Thales Philipe Rodrigues da Silva ◽  
Alexandra Dias Moreira ◽  
Taiane Gonçalves Novaes ◽  
Milene Cristine Pessoa ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Gestational Hypertension ◽  
Diagnosis Related Groups ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Hypertensive Disorder ◽  
Age Group ◽  
Cross Sectional ◽  
Discharge Data

OBJECTIVE: To evaluate whether age group, complications or comorbidities are associated with the length of hospitalization of women undergoing cesarean section. METHODS: A cross-sectional study was carried out between June 2012 and July 2017, with 64,437 women undergoing cesarean section and who did not acquire conditions during their hospital stay. Hospital discharge data were collected from national health institutions, using the Diagnosis-Related Groups system (DRG Brasil). The DRG referring to cesarean section with additional complications or comorbidities (DRG 765) and cesarean section without complications or associated comorbidities (DRG 766) were included in the initial diagnosis. The influence of age group and comorbidities or complications present at admission on the length of hospital stay was assessed based on the means of the analysis of variance. The size of the effect was verified by Cohen’s D, which allows evaluating clinical relevance. The criticality levels were identified using the Duncan test. RESULTS: The longest length of hospital stay was observed in the age group from 15 to 17 years old and among those aged 45 years old or more. The hospital stay of women with complications or comorbidities at the time of admission was also longer. Moreover, it was noted that the increase in criticality level was associated with an increase in the mean length of hospital stay. CONCLUSIONS: The length of hospital stay of women is higher among those belonging to the age group ranging from 15 to 17 years old and for those aged 45 years old or more. The presence of associated comorbidities, such as eclampsia, pre-existing hypertensive disorder with superimposed proteinuria and gestational hypertension (induced by pregnancy) with significant proteinuria increase the length of hospital stay. This study enabled the construction of distinct criticality level profiles based on the combination of age groups and the main comorbidities, which were directly related to the length of hospital stay.

scholarly journals Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature

2020 ◽  
Vol 17 (13) ◽  
pp. 4700
Author(s):  
Angelo Montana ◽  
Monica Salerno ◽  
Alessandro Feola ◽  
Alessio Asmundo ◽  
Nunzio Di Nunno ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Foreign Body Aspiration ◽  
Health Concern ◽  
Upper Airways ◽  
Significant Public Health Concern ◽  
Correct Execution ◽  
Significant Public Health ◽  
Free Environment

(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.

scholarly journals Foreign Body Aspiration of a Dental Bridge in the Left Main Stem Bronchus

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Monay Mahmoud ◽  
Syed Imam ◽  
Hetalben Patel ◽  
Matthew King
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Neuromuscular Diseases ◽  
Foreign Body Aspiration ◽  
Main Stem Bronchus ◽  
Life Threatening ◽  
Left Main Stem Bronchus ◽  
Successful Retrieval ◽  
Prompt Diagnosis ◽  
Life Threatening Event

Aspiration of tracheobronchial foreign bodies is a life-threatening event that occurs mainly in children. Occurrence in adults is rare and usually has a subtle presentation as most adults are unaware of aspiration of any foreign material. Decreased levels of consciousness, sedation, and neuromuscular diseases are major risk factors for foreign body aspiration in adults. Prompt diagnosis and intervention through foreign body retrieval are critical to prevent significant morbidity and mortality. Retrieval procedure is risky, and sudden decompensation of the patient can occur anytime. We are presenting an adult who accidentally aspirated his dental prosthesis during sleep and underwent successful retrieval of the dental bridge using flexible bronchoscopy.

Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree

2014 ◽  
Vol 128 (12) ◽  
pp. 1078-1083 ◽  
Author(s):  
G Behera ◽  
N Tripathy ◽  
Y K Maru ◽  
R K Mundra ◽  
Y Gupta ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Multidetector Computed Tomography ◽  
Diagnostic Tool ◽  
Foreign Bodies ◽  
Three Dimensional ◽  
Tracheobronchial Tree ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Virtual Bronchoscopy

AbstractObjectives:Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children.Methods:The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy.Results:A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent.Conclusion:Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.

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