Removal of Airway Foreign Body in a Premature Neonate

2021 ◽  
pp. 000348942199953
Author(s):  
Leighton Reed ◽  
Stephen Larson ◽  
Anthony Sheyn ◽  
Jennifer McLevy
Keyword(s):  
Foreign Body ◽  
Endotracheal Tube ◽  
Foreign Bodies ◽  
Effective Means ◽  
Premature Neonate ◽  
Positive Pressure ◽  
Premature Neonates ◽  
Chest X Ray ◽  
Airway Foreign Body ◽  
Extremely Premature Infant

Objective: Airway foreign bodies are the leading cause of infantile deaths and fourth among preschool children. Airway foreign bodies in extremely premature neonates represent a rare but potentially lethal entity. There are very few reports in the literature describing the treatment of such a condition in premature neonates. The objectives of this report are to describe the safe removal of an airway foreign body in an extremely premature infant using urologic instruments in a trans-endotracheal tube fashion and to review the literature for other techniques that have proven safe and effective, thereby adding technical options for future cases. Methods: We reviewed the case reported and reviewed pertinent literature. Results: A 2-week old, ex-24 3/7-week, 820-g pre-mature infant was intubated with a 2.5 endotracheal tube. After intubation, a 2-cm foreign body was discovered in the distal trachea by chest x-ray. The child’s respiratory status continuously deteriorated with increasing oxygen and positive pressure requirements. While remaining intubated, the child underwent direct suspension laryngoscopy, the ventilator circuitry was disconnected, and the object was successfully removed using a 1.2 mm rigid ureteroscope and 1.1 mm grasping forceps through the 2.5 endotracheal tube. Conclusion: This case report demonstrates the effectiveness of using a 1.2 mm ureteroscope and 1.2 mm urologic graspers to extract an airway foreign body from an extremely premature neonate through an endotracheal tube without paralyzing the patient. This method provides a safe and effective means of visualizing and, if necessary, manipulating the airway in a population prone to respiratory complications.

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.

Airway Foreign Body in a Premature Neonate

2017 ◽  
Vol 143 (9) ◽  
pp. 954
Author(s):  
Justin M. Wei ◽  
Edward T. Chang ◽  
Rebecca Arnold ◽  
Benjamin B. Cable
Keyword(s):  
Foreign Body ◽  
Premature Neonate ◽  
Airway Foreign Body

Utility of Conventional Radiography in the Diagnosis and Management of Pediatric Airway Foreign Bodies

1998 ◽  
Vol 107 (10) ◽  
pp. 834-838 ◽  
Author(s):  
Andrew B. Silva ◽  
Harlan R. Muntz ◽  
Randall Clary
Keyword(s):  
Foreign Body ◽  
Physical Examination ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Operative Intervention ◽  
Radiographic Imaging ◽  
Pediatric Airway ◽  
Diagnosis And Management ◽  
Breath Sounds ◽  
Airway Foreign Body

Pediatric airway foreign bodies are potentially life-threatening situations. The otolaryngologist is often consulted to aid in the diagnosis and management of these difficult cases. Although radiographic studies are often obtained, the decision for surgical intervention is usually based on a suspicious history and physical examination. Our hypothesis is that radiographic imaging should not alter the decision for surgical intervention. We retrospectively reviewed the cases of pediatric airway foreign bodies managed by the otolaryngology department at St Louis Children's Hospital between December 1990 and June 1996 with both radiographic imaging and operative intervention. Ninety-three cases of potential aspiration were identified, with a median patient age of 20 months. The most common presenting signs and symptoms were aspiration event (n = 82), wheezing (n = 76), decreased breath sounds (n = 47), cough (n = 39), respiratory distress (n = 17), fever (n = 16), pneumonia (n = 14), and stridor (n = 7). At the time of endoscopy, 73 patients were found to have an airway foreign body. The sensitivity and specificity of the imaging studies in identifying the presence of an airway foreign body in the 93 patients were 73% and 45%, respectively. Our decision for operative intervention was based on the history and physical examination, and was not changed in the presence of a negative radiographic study. The routine use of radiography should not alter the management of airway foreign bodies, providing that there is a well-equipped endoscopic team familiar with airway foreign bodies.

scholarly journals Disk Battery Ingestion A Malpractice Case that Results in Pneumonia

2016 ◽  
Vol 21 (3) ◽  
pp. 196-198 ◽  
Author(s):  
Cihat Şarkış ◽  
Selçuk Yazıcı ◽  
Muhammet Can
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Neck Trauma ◽  
Private Hospitals ◽  
Alkaline Batteries ◽  
X Ray ◽  
Clinical Impairment ◽  
Chest X Ray ◽  
Increasing Risk ◽  
Swallowed Foreign Bodies

Alkaline batteries have become the second most swallowed foreign bodies following coins. Most cases have an uncomplicated course, but some may lead to serious complications and even death.Here we report a 28 months old boy who had experienced discomfort, eating refusal, vomiting and slightly wheezing after falling from a sofa bed. He has been in three different county hospitals and two private hospitals due to complaints, has been examined by two pediatricians and a cranial surgeon. A cranial CT imaging, a cranial X-ray radiograph and a chest X-ray radiograph was obtained. Firstly, diagnosed as head and neck trauma, then diagnosed as acute bronchiolitis, and finally pneumonia. Hospitalized twice. Finally, a chest radiograph revealed a button battery in the esophagus. The foreign body was endoscopic removed. The child had a quick clinical impairment after removal of the battery.As a result, alkaline batteries with their increasing risk of engulfment poses very serious problems. The parents and physicians should be informed against increasing frequency of ingestion of alkaline batteries by infants and children. Also, clinicians should be careful about the risk of these batteries that they can cause pneumonia and infiltration which may make it difficult to detect the foreign body.

‘A parent’s kiss’: evaluating an unusual method for removing nasal foreign bodies in children

2000 ◽  
Vol 114 (8) ◽  
pp. 598-600 ◽  
Author(s):  
Marissa Botma ◽  
Roxana Bader ◽  
Haytham Kubba
Keyword(s):  
Foreign Body ◽  
Young Children ◽  
Foreign Bodies ◽  
Positive Pressure ◽  
Prospective Evaluation ◽  
First Line ◽  
Foreign Body Removal ◽  
Line Management

Nasal foreign bodies are a common problem in children. Various techniques have been described for removing the offending articles. Positive pressure techniques have long been described, and have many potential advantages, but are not yet in widespread use. The aim of this study was to evaluate the efficacy, safety and acceptability of a technique of mouth-to-mouth blowing. Of 19 children with intranasal foreign bodies, the technique was successful in 15 (79 per cent). The procedure caused little or no distress to the child, and no complications were encountered. All parents found the technique acceptable. This technique for nasal foreign body removal is, as far as we are aware, the first to be subjected to any prospective evaluation of effectiveness. We suggest that it should be used as the first line management for removing nasal foreign bodies in young children.

Airway Foreign Bodies

2020 ◽  
pp. 155-160
Author(s):  
C. Anthoney Lim ◽  
Rachel Whitney ◽  
Jeremy M. Rose
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Operative Management ◽  
Treatment Modalities ◽  
Foreign Body Removal ◽  
Life Threatening ◽  
Airway Foreign Body ◽  
Emergent Airway Management ◽  
Physical Findings

The presentation of an airway foreign body can range from benign to truly life-threatening. Respiratory tract obstruction from an airway or esophageal foreign body is relatively rare but remains a leading cause of morbidity and mortality among children. This chapter discusses the evaluation and management for inhaled and aspirated foreign bodies in the upper aerodigestive and lower respiratory tracts. Using anatomical areas as a systematic approach, common presentations, physical findings, and diagnostic workup including imaging options are reviewed. Treatment modalities including emergent airway management and foreign body removal are discussed, with a focus on procedures that can be performed in an emergency department setting and indications for operative management.

An Innovative Approach to Airway Foreign Body Management in an Extremely Premature Neonate

2019 ◽  
Vol 130 (5) ◽  
pp. 1236-1238 ◽  
Author(s):  
Sarah E. Hodge ◽  
Lauren Kilpatrick ◽  
Carlton Zdanski
Keyword(s):  
Foreign Body ◽  
Premature Neonate ◽  
Innovative Approach ◽  
Airway Foreign Body

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

1990 ◽  
Vol 104 (10) ◽  
pp. 778-782 ◽  
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.

scholarly journals Unsuspected Cause of Respiratory Distress: Unrecognized Esophageal Foreign Body

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Naima Baddouh ◽  
Lahcen Arjdal ◽  
Abdelaziz Raji ◽  
Mounir Bourrous
Keyword(s):  
Foreign Body ◽  
Respiratory Distress ◽  
Foreign Bodies ◽  
Thoracic Esophagus ◽  
Upper Respiratory Tract ◽  
Esophageal Foreign Body ◽  
Presenting Symptoms ◽  
History Of ◽  
Chest X Ray ◽  
Upper Thoracic

Summary. Foreign bodies in esophagus are avoidable accidents that occur most often in children younger than 3 years. The most common presenting symptoms are dysphagia, drooling, and vomiting. Revelation by respiratory distress is a rare and unusual condition. Objective. We describe and discuss the case of an esophageal foreign body, in which the patient presented with respiratory distress. Case report. A two-year-old child was admitted to the emergency department for acute respiratory distress. He had no history of choking episodes or dysphagia. Nevertheless, he was brought by his parents several times for a persistent cough and wheezing that was treated as asthma for a month. Pulmonary examination had revealed polypnea, suprasternal recession, scattered snoring, and diffuse wheeze. As part of his assessment, a chest X-ray was demanded. It had shown, as unexpected, a nonmetallic foreign body in the upper thoracic esophagus. A clothing button was removed by hypopharyngoscopy under sedation without any incident. Subsequent follow-up had not shown any complications related to this episode. Conclusion. Large esophageal foreign bodies can impinge on the trachea causing upper respiratory tract signs. We alert clinicians on variation in the presentation of foreign body ingestion, and we emphasize the importance of an early diagnosis and management.

An Unusual Foreign Body of the Esophagus

2005 ◽  
Vol 13 (1) ◽  
pp. 70-71
Author(s):  
ER Metin
Keyword(s):  
Status Epilepticus ◽  
Foreign Body ◽  
Endotracheal Tube ◽  
Endotracheal Intubation ◽  
Foreign Bodies ◽  
Convulsive Status Epilepticus ◽  
Esophageal Foreign Body ◽  
Unusual Foreign Body ◽  
Size And Shape ◽  
Rigid Esophagoscopy

Foreign bodies in the esophagus can result in serious complications depending on the size and shape of the ingested body. This report presents an unusual esophageal foreign body (endotracheal tube) caused by a physican who was inexperienced in endotracheal intubation during the treatment of generalized convulsive status epilepticus. When the patient was transferred to our hospital, rigid esophagoscopy was used to extract the endotracheal tube. There were no complications.

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