Esophageal Foreign Bodies in Pediatric Patients: A Thirteen-Year Retrospective Study

We discuss clinical symptoms and radiological findings of variable esophageal foreign bodies as well as therapeutic procedures in Caucasian pediatric patients. A retrospective study of 192 cases of suspected esophageal foreign bodies between 1998 and 2010 was conducted. Data were statistically analyzed by chi-square test. A foreign body was removed from a digestive tract of 163 children aged 6 months to 15 years (mean age 4.9). Most objects were located within cricopharyngeal sphincter. Dysphagia occurred in 43%, followed by vomiting (29%) and drooling (28%). The most common objects were coins. Plain chest X-rays demonstrated aberrations in 132 cases, and in doubtful situations an esophagram test was ordered. In the group of thirty-seven patients whose radiograms were normal, esophagoscopy revealed fifteen more objects, which were eventually successfully removed. No major complications occurred. Esophagram should be a second X-ray examination if an object is not detected in plain chest X-ray. We recommend a rigid esophagoscopy under general anesthesia in doubtful cases as a safe treatment for pediatric patients.

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PECULIARITIES OF DIAGNOSIS AND TREATMENT OF THE ESOPHAGEAL FOREIGN BODIES (COINS) IN CHILDREN – CLINICOSTATISTICAL STUDY

Romanian Journal of Pediatrics ◽

10.37897/rjp.2015.3.7 ◽

2015 ◽

Vol 64 (3) ◽

pp. 272-276

Author(s):

Corneliu Toader ◽

◽

Miorita Toader ◽

Iolanda Cristina Vivisenco ◽

◽

...

Keyword(s):

Retrospective Study ◽

Foreign Bodies ◽

Statistical Study ◽

Average Length ◽

X Ray ◽

Rigid Endoscopy ◽

Average Length Of Stay ◽

Study Results ◽

Esophageal Foreign Bodies

Objective. The authors performed a clinical and statistical study on cases of esophageal foreign bodies, with particular reference to ingested coins, admitted and treated in the ENT Department of the “Grigore Alexandrescu” Emergency Hospital for Children, between 01.01.2006 – 01.08.2007. Method and materials. A retrospective study, involving the interpretation and corroboration of the clinical and paraclinical findings of each case study. Results. Of all cases of foreign bodies, coins held the highest percentage; the average length of stay in hospital was 2 days; there were no cases of major complications (esophageal perforation, bleeding by intercepting a large vessel, mediastinitis); were also recorded particular cases that required special attention. Conclusion. All cases were approached and resolved by rigid endoscopy; shortening the time elapsed before presenting to ENT specialist facilitates the therapeutic approach, dramatically lowering the risk of complications; X-ray examination, although essential, can sometimes provide incomplete information, the diagnosis certainty being ensured only by endoscopy.

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Esophageal foreign bodies: Retrospective study in 203 cases

Medicinski pregled ◽

10.2298/mpns1004254p ◽

2010 ◽

Vol 63 (3-4) ◽

pp. 254-257 ◽

Cited By ~ 2

Author(s):

Goran Pudar ◽

Ljiljana Vlaski

Keyword(s):

Retrospective Study ◽

Foreign Body ◽

Foreign Bodies ◽

Structure Type ◽

Animal Origin ◽

Age Group ◽

Rigid Esophagoscopy ◽

Male Patients ◽

Esophageal Foreign Bodies ◽

Group 1

Introduction A retrospective study of Rigid Esophagoscopy, with the suspect of foreign body, was performed in General Hospital Zrenjanin 'Djordje Joanovic', at the Department of Otorhinolaryngology during the period of 1988 - 2007. Results and discussion The result of 517 esophagoscopies performed in the above period was 203 (39.26%) foreign bodies, with the average of 7,8 annually per 100.000 inhabitants. The patients age ranged from 1 to 91 years, (X = 48.98). Considering the gender, there were 95 male patients (46,79%), and 108 female patients (53.21%). The highest number of foreign bodies was found in the patients from the age group 60-69, (43/22.15%). According to the structure type of foreign bodies the most frequent were bones of animal origin (86/42.36%), followed by meat bolus (67/33%), metal coins (23/11.33%), and bodies of vegetable origin (14/6.89%). Metal coins were most frequently found in the age group 1-9. In regard to the level at which a foreign body was found (described in 157 cases, (77.30%)), 94 (59.87%) were found at the pharyngoesophageal junction, 58 (36.94%) were found in middle constriction of oesophagus, and in the area of diaphragmatic constriction and cardia there were 5 (3.18%) cases. The efficiency of removing foreign bodies by rigid esophagoscopy in the above mentioned sample was 99.01% (201/203). In 2 cases (0.99%), due to the impaction of foreign body, the patients were referred to the higher referent tertiary unit institution. Conclusion Foreign bodies represent a constant casuistics in Zrenjanin Municipality, dominantly connected to work of an otorhinolaryngologist on duty. Rigid esophagoscopy is safe and efficient diagnostic and therapeutic method.

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Radiological diagnosis of aspirated foreign bodies in children: Review of 343 cases

The Journal of Laryngology & Otology ◽

10.1017/s0022215100113891 ◽

1990 ◽

Vol 104 (10) ◽

pp. 778-782 ◽

Cited By ~ 95

Author(s):

Liancai Mu ◽

Deqiang Sun ◽

Ping He

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Correct Diagnosis ◽

X Rays ◽

Endoscopic Removal ◽

X Ray ◽

Abnormal Chest ◽

Mediastinal Shift ◽

Plain Chest ◽

Chest X Ray

AbstractIn our series of 400 Chinese children with foreign body aspiration (FBA),343 cases were evaluated by fluoroscopy and/or plain chest X-rays before endoscopic removal of the foreign bodies. The majority of the foreign bodies (FBs) were organic (378/400, 94.5 per cent). The results showed that mainstem bronchial foreign bodies were diagnosed correctly in 68 per centof cases compared with 65 per cent correct diagnoses with segmental bronchial foreign bodies, but only 22 per cent correct diagnoses with tracheal, and 0 per cent correct diagnosis in those with laryngeal foreign bodies. Eighty per cent (32/40) of the children with laryngotracheal FBs had normal X-ray findings, whereas 67.7 per cent (205/303) of the children with bronchial FBs had abnormal chest X-ray findings. The most common positive radiological signs in the children with tracheobronchial FBs were obstructive emphysema (131/213, 62 per cent) and mediastinal shift (117/213, 55 percent). The incidence of major complications was related not only to the size of the foreign body and its location but also the duration since aspiration. The most common types of bronchial obstructions by airway FBs are discussed.

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Foreign bodies in the oesophagus on the example of patients of the Department of Paediatric Otolaryngology at the Medical University of Warsaw

New Medicine ◽

10.25121/newmed.2018.22.4.119 ◽

2018 ◽

Vol 22 (4) ◽

Author(s):

Małgorzata Badełek-Izdebska ◽

Lidia Zawadzka-Głos

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Clinical Symptoms ◽

Interventional Treatment ◽

X Ray ◽

Foreign Objects ◽

Imaging Results ◽

Rigid Esophagoscopy ◽

Therapeutic Procedures ◽

Medical University

Introduction. Foreign bodies in the oesophagus are one of the more frequent non-infectious reasons for a child’s visit to the hospital emergency room. Most often, children swallow items accidentally while having fun, learning about the world with the help of their senses, as well as when eating meals. It is coins, plastic or metal fragments of objects that are usually swallowed. Also, hard pieces of food may stick to the oesophagus. Aim. The aim of the study was to analyse clinical symptoms as well as diagnostic and therapeutic procedures in patients with suspicion of the presence of a foreign body in the oesophagus. Material and methods. The authors analysed clinical data of 49 patients hospitalized in the Department of Paediatric Otolaryngology at the Medical University of Warsaw due to the suspicion or presence of a foreign body in the oesophagus. What was also analysed, was the diagnostic and therapeutic process during which the initial diagnosis was confirmed or excluded. Results. The authors analysed the symptoms with which patients came to the hospital, the diagnostic and therapeutic procedures used and the results of treatment. Attention was paid to diagnostic difficulties that may be encountered by a physician in the Admission Room, and then an otolaryngologist qualifying the patient for interventional treatment or deciding on conservative procedures. Possible complications that may occur during ezophagoscopy are described. Conclusions. Foreign bodies in the oesophagus are a common problem in the paediatric population. The most common foreign objects are coins, metal or plastic items or food. The most dangerous foreign objects are disc batteries and sharp, large objects. Diagnostic imaging includes chest and neck X-ray, and in the case of non-contrasting bodies – X-ray with barium or a cotton ball soaked in contrast. The presence of clinical symptoms and/or imaging results suggesting the presence of a foreign body in the oesophagus is an indication for oesophageal endoscopy under general anaesthesia. Both rigid esophagoscopy and the use of a flexible fiberscope are burdened with a certain degree of risk, of which the parents should be informed before those are performer.

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CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS FROM TREATMENT OF FOREIGN BODIES INGESTION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.4.10 ◽

2016 ◽

pp. 63-69

Author(s):

Hoang Cuong Vo ◽

Thanh Dang ◽

Phuong Nam Tran ◽

Thanh Thai Le

Keyword(s):

Foreign Body ◽

Clinical Characteristics ◽

Foreign Bodies ◽

University Hospital ◽

Age Group ◽

Central Hospital ◽

Results Of Treatment ◽

Rigid Esophagoscopy ◽

Flexible Esophagoscopy ◽

Esophageal Foreign Bodies

Background: Foreign bodies ingestion is a emergency in otology, knowledge of people about foreign bodies ingestion is not enough. Objective: To study the clinical characteristics, paraclinical characteristics and results of treatment from foreign bodies ingestion in Hue Central Hospital and Hue University Hospital. Methods and patiens: A cross descriptive and prospective study over the period from 6/2014 to 5/2016, total are 137 patients come to be diagnosised and treatmented. Results: the average age is 35 years old. Gender: male (51.8%) and women (48.2%). Adults (84.7%) having more than children (15.3%). Age group from 16-30 years is highest (32.8%). There are 95.7% of organic foreign bodies, 4.3% are inorganic foreign bodies. There are 90.5% of patients on diagnosis and treatment in stages less inflammation, arthritis 8.0% in the period and 1.5% in the period complications. Foreign body in the throat problems (73.7%), esophageal foreign bodies (26.3%). Pick up directly foreign bodies 54%, indirectly by the mirror 11.7% and endoscopy 8%, rigid esophagoscopy is 17.5%, flexible esophagoscopy is 7.3%, cervicotomy is 1.5%. Conclusion: Practing direction with in the oropharynx foreign body, using the larynx mirror or endoscopy with in the laryngopharynx for the esophagus foreign bodies, rigid esophagoscopy is better. Key words: Foreign bodies ingestion

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CHEST X RAY SCORE AND CLINICAL SEVERITY IN COVID-19 PATIENTS

10.36106/ijsr/2506669 ◽

2021 ◽

pp. 31-32

Author(s):

Sheeba Rana ◽

Vicky Bakshi ◽

Yavini Rawat ◽

Zaid Bin Afroz

Keyword(s):

Retrospective Study ◽

Medical Records ◽

Scoring Systems ◽

Clinical Severity ◽

X Rays ◽

Antigen Test ◽

X Ray ◽

Classi Cation ◽

Chest X Ray ◽

Male Subjects

INTRODUCTION: Various chest X-ray scoring systems have been discovered and are employed to correlate with clinical severity, outcome and progression of diseases. With, the coronavirus outbreak, few chest radiograph classication were formulated, like the BSTI classication and the Brixia chest X-ray score. Brixia CXR scoring is used for assessing the clinical severity and outcome of COVID-19. This study aims to compare the Brixia CXR score with clinical severity of COVID-19 patients. MATERIAL& METHODS:This was a retrospective study in which medical records of patients aged 18 years or above, who tested for RTPCR or st st Rapid Antigen Test (RAT) for COVID positive from 1 February 2021 to 31 July 2021 (6 months) were taken. These subjects were stratied into mild, moderate and severe patients according to the ICMR guidelines. Chest X Rays were obtained and lesions were classied according to Brixia scoring system. RESULTS: Out of these 375 patients, 123 (32.8%) were female and 252 (67.2%) were male subjects. The average brixia score was 11.12. Average Brixia CXR score for mild, moderate and severe diseased subjects were 5.23, 11.20, and 14.43 respectively. DISCUSSION:The extent of chest x-ray involvement is proportional to the clinical severity of the patient. Although, a perplexing nding was that the average Brixia score of the female subjects were slightly higher than their male counterparts in the same clinical groups. CONCLUSION: Brixia CXR score correlates well with the clinical severity of the COVID-19.

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Correlation between chest x-ray findings and outcomes of patients with mechanical ventilation

Paediatrica Indonesiana ◽

10.14238/pi53.1.2013.6-11 ◽

2013 ◽

Vol 53 (1) ◽

pp. 6

Author(s):

Indah Nurhayati ◽

Muhammad Supriatna ◽

Kamilah Budhi Raharjani ◽

Eddy Sudijanto

Keyword(s):

Mechanical Ventilation ◽

Retrospective Study ◽

Pleural Effusion ◽

Respiratory Distress ◽

Pulmonary Edema ◽

Patient Outcomes ◽

Morbidity And Mortality ◽

Chi Square ◽

X Ray ◽

Chest X Ray

Background Most infants and children admitted to the pediatricintensive care unit (PICU) have respiratory distress and pulmonarydisease as underlying conditions. Mechanical ventilation may beused to limit morbidity and mortality in children with respiratoryfailure.Objective To assess a correlation between chest x-ray findingsand outcomes of patients with mechanical ventilation.Methods This retrospective study was held in Dr. KariadiHospital, Semarang, Indonesia. Data was collected from themedical records of children admitted to the PICU from Januaryto December 2010, who suffered from respiratory distress andused mechanical ventilation. We compared chest x-ray findings tothe outcomes of patients. Radiological expertise was provided byradiologists on duty at the time. Chi-square and logistic regressiontests were used for statistical analysis.Results There were 63 subjects in our study, consisting of 28 malesand 35 females. Patient outcomes were defined as survived or died,43 subjects ( 68%) and 20 subjects (3 2%), respectively. Chest x-rayfindings revealed the following conditions: bronchopneumonia48% (P=0.298; 95%CI 0.22 to 1.88), pleural effusion 43%(P=0.280; 95%CI 0.539 to 4.837) , pulmonary edema 6%(P=0.622; 95%CI 0.14 to 14.62) and atelectasis 3% (P=0.538;95%CI 0.03 to 7 .62). None of the chest x-ray findings significantlycorrelated to patient outcomes.Conclusion Chest x-ray findings do not correlate to patientoutcomes in pediatric subjects with mechanical ventilation inthe PICU of Dr. Kariadi Hospital, Semarang, Indonesia.

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Chest x-ray findings and outcomes of children with suspected ventilator .. associated pneumonia

Paediatrica Indonesiana ◽

10.14238/pi52.4.2012.233-8 ◽

2012 ◽

Vol 52 (4) ◽

pp. 233

Author(s):

Neni Sumarni ◽

Muhammad Sholeh Kosim ◽

Mohammad Supriatna ◽

Eddy Sudijanto

Keyword(s):

Retrospective Study ◽

Patient Outcomes ◽

Pulmonary Infection ◽

Ventilator Associated Pneumonia ◽

Chi Square ◽

X Ray ◽

Chest X Ray ◽

Hospital Acquired ◽

Pediatric Icu ◽

The Relationship

Background Ventilator􀁖associated pneumonia (VAP) is anosocomial infection in patients who have received mechanicalventilation (MV), either by endotracheal intubation ortracheostomy, for more than 48 hours. YAP represents 80% ofall hospital􀁖acquired pneumonias. VAP incidence varies from5.1 %􀁖33.3%. The modified clinical pulmonary infection scoreis a criteria for diagnosing suspected YAP and typically includesradiographic evidence. YAP is associated with significantmorbidity and mortality.Objective To determine the relationship between chest x􀁖rayfindings and outcomes in children Mth suspected VAP.Methods This retrospective study was held in Dr. Kariadi Hospitalfrom January - December 2010. Data was collected from medicalrecords of pediatric ICU (PICU) patients with suspected VAP.Chest x􀁖ray findings and patient outcomes were recorded. X􀁖rayfindings were assessed by the on􀁖duty radiologist. Chi square testwas used for statistical analysis.Results Subjects were 30 children consisting of 14 males and 16females. Patient outcomes were 23 patients survived and 7 patientsdied. Chest x􀁖ray findings were categorized into the followinggroups and compared to patient survivability: diffuse infiltrates76.7% (OR􀁗0.694; P􀁗0.532; 95% CI 0.102 to 4.717), localhedinfiltrates 13.3% (OR􀁗4.200; P􀁗 0.225; 95% CI 0.470 t037.49),and no infiltrates 10% (OR􀁗 1.222; P􀁗 0.436; 95% CI 0.593 to0.926). None of the x􀁖ray findings had a significant correlationto patient outcomes.Conclusion There was no significant relationship between chestx􀁖ray findings and outcomes in children with suspected VAP.[Paediatr rndones. 2012;52:233-8].

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Physician Compliance With Bronchiolitis Guidelines in Pediatric Emergency Departments

Clinical Pediatrics ◽

10.1177/0009922819850462 ◽

2019 ◽

Vol 58 (9) ◽

pp. 1008-1018 ◽

Cited By ~ 2

Author(s):

Andrea V. Rivera-Sepulveda ◽

Terri Rebmann ◽

James Gerard ◽

Rachel L. Charney

Keyword(s):

Online Survey ◽

Pediatric Emergency ◽

Systemic Steroid ◽

X Rays ◽

Chi Square ◽

X Ray ◽

American Academy Of Pediatrics ◽

Physician Compliance ◽

Chest X Ray ◽

Viral Testing

An online survey was administered through the American Academy of Pediatrics (AAP) Section of Emergency Medicine Survey Listserv in Fall, 2017. Overall compliance was measured as never using chest X-rays, viral testing, bronchodilators, or systemic steroids. Practice compliance was measured as never using those modalities in a clinical vignette. Chi-square tests assessed differences in compliance between modalities. t tests assessed differences on agreement with each AAP statement. Multivariate logistic regression determined factors associated with overall compliance. Response rate was 47%. A third (35%) agreed with all 7 AAP statements. There was less compliance with ordering a bronchodilator compared with chest X-ray, viral testing, or systemic steroid. There was no association between compliance and either knowledge or agreement with the guideline. Physicians with institutional bronchiolitis guidelines were more likely to be practice compliant. Few physicians were compliant with the AAP bronchiolitis guideline, with bronchodilator misuse being most pronounced. Institutional bronchiolitis guidelines were associated with physician compliance.

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Automated segmentation and diagnosis of pneumothorax on chest X-rays with fully convolutional multi-scale ScSE-DenseNet: a retrospective study

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01325-5 ◽

2020 ◽

Vol 20 (S14) ◽

Author(s):

Qingfeng Wang ◽

Qiyu Liu ◽

Guoting Luo ◽

Zhiqin Liu ◽

Jun Huang ◽

...

Keyword(s):

Retrospective Study ◽

Automatic Segmentation ◽

Medical Emergency ◽

Dice Similarity Coefficient ◽

X Rays ◽

X Ray ◽

Learning Framework ◽

Multi Scale ◽

Life Threatening ◽

Chest X Ray

Abstract Background Pneumothorax (PTX) may cause a life-threatening medical emergency with cardio-respiratory collapse that requires immediate intervention and rapid treatment. The screening and diagnosis of pneumothorax usually rely on chest radiographs. However, the pneumothoraces in chest X-rays may be very subtle with highly variable in shape and overlapped with the ribs or clavicles, which are often difficult to identify. Our objective was to create a large chest X-ray dataset for pneumothorax with pixel-level annotation and to train an automatic segmentation and diagnosis framework to assist radiologists to identify pneumothorax accurately and timely. Methods In this study, an end-to-end deep learning framework is proposed for the segmentation and diagnosis of pneumothorax on chest X-rays, which incorporates a fully convolutional DenseNet (FC-DenseNet) with multi-scale module and spatial and channel squeezes and excitation (scSE) modules. To further improve the precision of boundary segmentation, we propose a spatial weighted cross-entropy loss function to penalize the target, background and contour pixels with different weights. Results This retrospective study are conducted on a total of eligible 11,051 front-view chest X-ray images (5566 cases of PTX and 5485 cases of Non-PTX). The experimental results show that the proposed algorithm outperforms the five state-of-the-art segmentation algorithms in terms of mean pixel-wise accuracy (MPA) with $$0.93\pm 0.13$$ 0.93 ± 0.13 and dice similarity coefficient (DSC) with $$0.92\pm 0.14$$ 0.92 ± 0.14 , and achieves competitive performance on diagnostic accuracy with 93.45% and $$F_1$$ F 1 -score with 92.97%. Conclusion This framework provides substantial improvements for the automatic segmentation and diagnosis of pneumothorax and is expected to become a clinical application tool to help radiologists to identify pneumothorax on chest X-rays.

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