Five-Year Retrospective Study with Special Reference to Management

1980 ◽  
Vol 89 (5) ◽  
pp. 437-442 ◽  
Author(s):  
Seymour R. Cohen ◽  
Wayne I. Herbert ◽  
George B. Lewis ◽  
Kenneth A. Geller

The charts of 143 patients with foreign bodies in the larynx and tracheobronchial tree who were admitted to the Childrens Hospital of Los Angeles during the period 1973 to 1978 were reviewed. Of these children 84 were male and 59 were female. One hundred were private patients and forty-three were clinic patients. Of these foreign bodies 60 were nut meat which is by far the most common foreign body of the tracheobronchial tree. All foreign bodies were successfully removed. One hundred twenty-six were discharged within the first 24 hours after admission and treatment. Fifty-one or 36% of these patients were discharged on the same day after the foreign body was removed. Sixty-two of the foreign bodies were in the left bronchial tree, while 55 were in the right bronchial tree. One hundred thirty-eight were endoscoped under general anesthesia using the apneic technique and five patients were treated with oxygen standby only because of severe respiratory obstruction. A detailed description of the use of apneic technique with profound muscle relaxation, the avoidance of preoperative medication and the team approach to ventilating the patients are all described. The advantage of general anesthesia, and the potential intraoperative and postoperative problems are reviewed. Of the total number of cases 13 % were between 4 and 11 months of age, 44% were between 12 and 23 months of age and 57% were over 23 months of age.

Author(s):  
Anastasios-Panagiotis Chantzaras ◽  
Panagiota Panagiotou ◽  
Spyridon Karageorgos ◽  
Konstantinos Douros

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.


1988 ◽  
Vol 102 (11) ◽  
pp. 1029-1032 ◽  
Author(s):  
Amit Banerjee ◽  
K. S. V. K. Subba Rao ◽  
S. K. Khanna ◽  
P. S. Narayanant ◽  
B. K. Gupta ◽  
...  

AbstractInhalation of a foreign body into the respiratory passage can be a serious and sometimes fatal childhood accident. In this paper we analyze the management of 223 children with laryngo-tracheo-bronchial foreign bodies. Children below three years of age were found to be the most vulnerable. The majority of the patients were boys. Over a quarter of the patients did not present with a history of inhalation. Only 52 per cent reported within 24 hours of inhalation. Endoscopic removal was possible in all but nine cases. One hundred and fort eight (66.4 per cent) of the recovered foreign bodies were organic in origin, the majority of them being peanuts. In one hundred and five (47.1 per cent) the objects found their way into the right bronchial tree. There were two deaths. The modalities of diagnosis and management are discussed.


1980 ◽  
Vol 89 (5) ◽  
pp. 434-436 ◽  
Author(s):  
Bruce F. Rothmann ◽  
Clifford R. Boeckman

In a study of 225 patients with foreign bodies in the larynx, trachea and bronchi, 77 % were 36 months of age or less. The male-female ratio was 2:1. Food or food derivatives were the causative agent in 70% of the cases, with 38% due to a portion of nut. The foreign body involved the right and left bronchus with equal frequency. A choking episode followed by an audible wheeze (55 %) was the most common presenting complaint. Obstructive emphysema was demonstrated in 60 % and was best demonstrated by inspiration-expiration chest roentgenograms or fluoroscopy. A radio-opaque object was seen in 13 %. Two hundred ten foreign objects (93 %) were removed by endoscopy. Four patients required pulmonary resection for bronchiectasis and in three patients bronchotomy was performed. Five patients expelled the foreign body spontaneously, two patients were transferred to another hospital, and one foreign body was not recovered. There was no mortality.


PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 303-304
Author(s):  
Donald B. Hawkins ◽  
Emily J. Kahlstrom ◽  
Eithne F. MacLaughlin ◽  
Monique F. Margetis

Foreign bodies in the airway often present problems for physicians who treat children. The following case report illustrates some of these problems. CASE REPORT A 6-year-old boy was admitted to the Pediatric Respiratory Disease Service of the Los Angeles County-University of Southern California Medical Center with a complaint of persistent nonproductive cough since awakening the morning of the previous day. He also had a history of discharge from his right nostril for eight months, at times foul-smelling. During this time, he had seen doctors on three occasions; twice antibiotics had been prescribed for sinus infection. He was in no distress, and demonstrated no respiratory difficulty.


1981 ◽  
Vol 90 (4) ◽  
pp. 406-408 ◽  
Author(s):  
Mary J. Spencer ◽  
Victoria E. Millet ◽  
James P. Dudley ◽  
Jessie L. Sherrod ◽  
Yvonne J. Bryson

Many vegetable foreign bodies can produce serious pulmonary complications because of chemical irritation to the airway. Barley grass, a type of grasshead, does not induce such a reaction because of its resistance to organic decay. Complications which may occur are illustrated by the clinical course of two patients with aspiration of this foreign body. In the first patient the grasshead entered the trachea with the flowering unit first and the stem following. In the second patient the stem entered the trachea first. Recurrent pneumonias were noted in the first patient. Despite its presence in the right stem bronchus for three years, no further episodes of pneumonia followed its removal. In the second patient the grassheads could not be removed endoscopically. They migrated into the right lower lobe producing pneumonia and ultimately resulting in a brain abscess. The difference of entry of the same foreign body into the trachea, stem first versus flowering unit first, is an essential factor in altering the clinical outcome.


1930 ◽  
Vol 26 (9) ◽  
pp. 941-941
Author(s):  
B. Goland

Abstracts. Otorhinolaryngology. Prof. Uffenrode (D. med. Woch. 1929. No. 25.) describes 2 very interesting cases from his practice. 1. To remove peas from the ears of a 5-year-old child, a family doctor used tweezers. In view of the child's strong anxiety, chlorine ethyl anesthesia was applied, but the removal of foreign bodies from the ears was not possible; deep wound in the right ear canal. Secondary chlorine - ethyl anesthesia; the foreign body was removed from the left ear by washing, from the right ear it was not possible. The next day, an otorhinolaryngologist will remove the foreign body from the right ear; a wound of the tympanic membrane was established.


2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Javeria Nasir ◽  
Anum Javed ◽  
Owais Arshad ◽  
Mohammad Hanif` Chatni

Ophthalmologists, including general practitioners definitely encounter ocular foreign bodies in their clinics. Theconjunctival fornices are potential sites of impaction. We report a case of a 9-month infant boy who was referred to us for a persistent lower lid swelling for one month. He had already been to an eye specialist before presenting to us. Upon examination, a round, pink coloured, toy cart-wheel came out of his lower eye lid of the right eye. Surprisingly, there was no associated conjunctival or adnexal damage. The authors wish to emphasize the importance of taking a thorough history and adequate general physical examination. A missing part of a toy, elucidated on history, should always raise the suspicion among parents and/or care givers for a probable foreign body in infants and children.


PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 959-959
Author(s):  
Glenn Isaacson

Jackson and Jackson,1 in their landmark text, describe over 3000 foreign bodies of the air and food passages removed during their careers. Of these, 565 were vegetative and from the tracheobronchial tree. In their detailed list of foreign body types, sunflower seeds are not mentioned. A review of airway foreign bodies removed from children in the last 4 years at St. Christopher's Hospital for Children, the Jacksons' main operative hospital for children, showed a remarkable change.


Inhaled foreign bodies 76 Everything from peas to bicycle tyre caps can make their way into the bronchial tree if circumstances allow! Lodging of a foreign body in the trachea is rare, and so this section only deals briefly with tracheal obstruction ( Chapter 42...


2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Ratna Priya ◽  
Sheetal Shelke ◽  
Kartik Krishnan

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.


Sign in / Sign up

Export Citation Format

Share Document