scholarly journals Suitability of òhe modality virtual bronchoscopy with aspiration of a foreign body

2018 ◽  
Vol 16 (3) ◽  
pp. 224-232
Author(s):  
M.A. Mitev ◽  
S. Valkanov ◽  
V. Ribarova ◽  
B. Parvanova
Keyword(s):  
Foreign Body ◽  
High Sensitivity ◽  
Tracheobronchial Tree ◽  
Accurate Information ◽  
Virtual Bronchoscopy ◽  
Non Invasive ◽  
Accurate Localization ◽  
Life Threatening ◽  
Sensitivity Specificity ◽  
Inflammatory Changes

Aspirations of foreign bodies are life-threatening among children and elderly patients requiring urgent medical assistance. The aim of the study is to present summarized results from various authors' studies to reveal VB's diagnostic abilities for suspected aspiration of a foreign body. VB has been shown to be a particularly useful non-invasive modality for the complex tracheobronchial tree assessment for suspected aspiration of a foreign body due to its high sensitivity, specificity and validity. MDCT VB with MPR allows accurate localization of the foreign body, but in secondary inflammatory changes and secretions it does not provide accurate information about the form and type of the finding. VB cannot replace FB ("gold standard") but successfully supports and complements it. MDCT could provide early diagnosis in cases of suspected aspiration of a foreign body in children and adults and avoid real bronchoscopy in patients with poor overall condition.

Reducing the number of rigid bronchoscopies performed in suspected foreign body aspiration cases via the use of chest computed tomography: is it safe? A literature review

2014 ◽  
Vol 129 (S1) ◽  
pp. S1-S7 ◽  
Author(s):  
P Tuckett ◽  
A Cervin
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Gold Standard ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Review Of Literature ◽  
Chest Computed Tomography ◽  
Non Invasive ◽  
Life Threatening ◽  
Sensitivity Specificity

AbstractBackground:Foreign body aspiration is common and potentially life threatening. Although rigid bronchoscopy has the potential for serious complications, it is the ‘gold standard’ of diagnosis. It is used frequently in light of the inaccuracy of clinical examination and chest radiography. Computed tomography is proposed as a non-invasive alternative to rigid bronchoscopy.Objective:This study aimed to evaluate the accuracy and safety of computed tomography used in the diagnosis of suspected foreign body aspiration, and compare this with the current gold standard, in order to examine the possibility of using computed tomography to reduce the number of diagnostic rigid bronchoscopies performed.Method:The study comprised a review of literature published from 1970 to 2013, using the PubMed, Scopus, Web of Knowledge, Embase and Medline electronic databases.Results:The sensitivity for computed tomography ranged between 90 and 100 per cent, with four studies demonstrating 100 per cent sensitivity. Specificity was between 75 and 100 per cent. Radiation exposure doses averaged 2.16 mSv.Conclusion:Computed tomography is a sensitive and specific modality in the diagnosis of foreign body aspiration, and its future use will reduce the number of unnecessary rigid bronchoscopies.

scholarly journals Right ventricular thrombus, a challenge in imaging diagnostics: a case series

2021 ◽  
Author(s):  
Massimo Barbagallo ◽  
Daryl Naef ◽  
Pascal Köpfli ◽  
Urs Hufschmid ◽  
Tilo Niemann ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Case Series ◽  
General Medicine ◽  
High Sensitivity ◽  
Cost Effective ◽  
Ventricular Thrombus ◽  
Threatening Condition ◽  
Life Threatening ◽  
Therapeutic Decision Making ◽  
Sensitivity Specificity

Abstract Background Presence of right ventricular thrombus (RVT) is a rare but life-threatening condition, thus immediate diagnosis and therapy are mandatory. Unfortunately, detection and distinction from intraventricular tumor masses or vegetations represents a complex task. Furthermore, consecutive therapy is principally led by clinical presentation without considering morphological features of the thrombus. Current literature suggests a multimodal non-invasive imaging approach. In this paper, we discuss the role of cardiac magnetic resonance (CMR) for the detection of RVT in patients with pulmonary embolism (PE). We consider the relatively expensive and not broadly available imaging procedure and weigh it up to its assumed high sensitivity, specificity and importance for differential diagnosis and therapeutic decision making. Case Summary In this case series we report three cases of RVT with concomitant PE, whereof two were missed during routine cardiac workup by transthoracic echocardiography (TTE) and computer tomography (CT). CMR led to detection and further characterization of the thrombi in both cases. These patients were diagnosed and treated at the Cantonal Hospital of Baden in the division of General Medicine. Conclusions CMR reliably detects and characterizes RVT, even under unfavourable conditions for echocardiography such as arrhythmia, adiposity or in posterior position of RVT. Obtained information could facilitate the choice of therapeutic approach (anticoagulation vs. systemic lysis, vs. surgical thrombectomy). Future risk-stratification scores will promote cost-effective use of CMR.

scholarly journals Broken metallic tracheostomy tube migrating into the tracheobronchial tree

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Ratna Priya ◽  
Sheetal Shelke ◽  
Kartik Krishnan
Keyword(s):  
Foreign Body ◽  
Tracheostomy Tube ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Life Saving ◽  
Wear And Tear ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Periodic Replacement

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.

scholarly journals Application of the Virtual Bronchoscopy in Children with Suspected Aspiration of the Foreign Body - Case Report

2016 ◽  
Vol 17 (4) ◽  
pp. 361
Author(s):  
Gordana Kostic ◽  
Marina Petrovic ◽  
Slavica Markovic ◽  
Jasmina Knezevic ◽  
Zoran Igrutinovic ◽  
...  
Keyword(s):  
Foreign Body ◽  
Fiber Optic ◽  
Inhaled Corticosteroids ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Rigid Bronchoscopy ◽  
Virtual Bronchoscopy ◽  
Peripheral Airways ◽  
Life Threatening ◽  
Body Case

Abstract In diagnosing the aspiration of the foreign body (AFB) in children most important are: medical history, clinical signs and positive radiography of the lungs. Common dilemmas in the diff erential diagnosis are life-threatening asthma attacks or difficult pneumonia. Conventional rigid bronchoscopy (RB) is not recommended as a routine method. Virtual bronchoscopy (VB) can be a diagnostic tool for solving dilemmas. Fiber-optic bronchoscopy (FOB) has a therapeutic stake in severe cases. Herein, we describe a girl, at the age of 6, who was hospitalized due to rapid bronchoconstriction and based on the anamnesis, clinical symptoms and physical fi ndings the suspicion was that she aspirated the foreign body. Due to the poor general condition and possible sequel, the idea of RB was dropped out. Multidetector computed tomography of the chest and VB was performed and AFB was not found. Due to positive epidemiological situation, virus H1N1 was excluded. FOB established that the foreign body does not exist in the airways. During bronchoscopy numerous castings are aspirated from the peripheral airways which lead to faster final recovery. With additional procedures, the diagnosis of asthma was confirmed and for girl that was the first attack. Along with inhaled corticosteroids as prevention she feels well. Virtual bronchoscopy can be successfully used as a valid diagnostic procedure in suspected foreign body in the children’s lungs, but fiber-optic bronchoscopy remains most important diagnostic and therapeutic method.

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.

scholarly journals A comparative study between placental alpha microglobulin-1 rapid immunoassay and standard diagnostic methods for detection of rupture of membranes

2018 ◽  
Vol 7 (5) ◽  
pp. 1813
Author(s):  
Hemant Deshpande ◽  
Umesh Sabale ◽  
C. S. Madkar ◽  
Anuja Bobe
Keyword(s):  
False Negative ◽  
High Sensitivity ◽  
Diagnostic Methods ◽  
Step Test ◽  
Non Invasive ◽  
Emergency Cesarean ◽  
One Step ◽  
Conventional Methods ◽  
Sensitivity Specificity ◽  
Very High

Background: To determine the efficacy of an immunoassay to measure levels of placental alpha-microglobulin-1 in cervico-vaginal secretions.Methods: 100 ANC cases admitted in Dr D. Y. Patil Hospital with symptoms of rupture of membranes during study period. Inclusion criteria-Pregnant women who presented with symptoms of ROM either in labour or not in labour, gestational age from 28 weeks onwards and who have given consent.Results: In 9 cases, the immunoassay test was negative, in 91 cases, it was positive and in one case, the liquor had a lot of meconium, the woman had to undergo an emergency cesarean section. This patient was deemed to have a false negative result by the test. Pooling was positive in 87 cases, nitrazine test in 86 cases and ferning in 88 cases. Hence, in comparison to immunoassay test which had 100% specificity and 98.91% sensitivity due to incomplete evaluation, nitrazine test had 95.58% sensitivity and 100% specificity, Pooling has 97.79% sensitivity and 100% specificity, whereas ferning has 98.34% sensitivity and 100% specificity.Conclusions: The PAMG1 is a non-invasive, rapid, one step test with very high sensitivity, specificity and accuracy as compared to the conventional methods together and also individually. Preforming this test instead of conventional methods can aid the early detection of rupture of membranes and largely affect the outcome of maternal and fetal health as timely decision can be taken once diagnosis is confirmed.

scholarly journals A White Board Needle in the Trachea

2013 ◽  
Vol 12 (4) ◽  
pp. 449-452
Author(s):  
SBA Rahim ◽  
T Maruthamuthu ◽  
LL Chooi ◽  
A Singh ◽  
MRBM Yunus
Keyword(s):  
Foreign Body ◽  
Medical Science ◽  
Vital Signs ◽  
Tracheobronchial Tree ◽  
Foreign Body Aspiration ◽  
X Ray ◽  
White Board ◽  
Life Threatening ◽  
History Of

Foreign body aspiration often occurs amongst extreme age. Most of aspirated object are; nuts, nails, pins, coins, metal piece and dental appliances. Foreign body aspiration can be life threatening. Patients with foreign body aspiration may present with choking, coughing, wheezing, haemoptysis, asphyxia and even death. The symptoms and severity depend on the site of obstruction. This is a case of 9 year old boy provided the history of aspiration of white board needle. He had persistent cough but examination revealed normal vital signs. Radiological examination confirmed needle like radio opaque material in his trachea. This case report depicts the management and bronchoscope as diagnostic procedure of this case and role of X-ray and CT scan in dealing with foreign body in the tracheobronchial tree. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16668 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 449-452

scholarly journals TECHNICAL PARAMETERS AND CRITERIA FOR VIRTUAL BRONCHOSCOPY IN DIAGNOSTICS OF TRACHIAL AND BRONCHIAL RUPTURES

2020 ◽  
Vol 18 (2) ◽  
pp. 165-169
Author(s):  
M. Mitev
Keyword(s):  
High Reliability ◽  
Tracheobronchial Tree ◽  
Invasive Technique ◽  
Virtual Bronchoscopy ◽  
Technical Parameters ◽  
Non Invasive ◽  
Reliability Sensitivity ◽  
Diagnostic Capabilities ◽  
Key Indicators

VB is a non-invasive technique and follow-up tool tolerant of most patients, requiring a precise method of diagnosis, especially in ruptures with the formation of high-grade stenoses for which FB is not applicable, as well as in children and elderly or severely ill patients. The study aims to track the technical parameters, key indicators, and criteria for optimizing the diagnostic capabilities of Virtual bronchoscopy (VB) in tracheal and bronchial ruptures. Optimization of the technical parameters of the scans taking into account the age of the patient, the weight, the size, the nature of the ruptures and the severity of the diagnosis; the application of appropriate criteria and parameters for the diagnosis and evaluation of the tracheobronchial tree, combined with the capabilities of modern equipment, guarantee the high reliability, sensitivity, and specificity of the VB method.

scholarly journals Office Removal of a Subglottic Bread Clip

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
David E. Rosow ◽  
Si Chen
Keyword(s):  
Foreign Body ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Upper Airway ◽  
Tracheobronchial Tree ◽  
Life Threatening ◽  
Successful Removal ◽  
Lidocaine Spray ◽  
Threatening Situation ◽  
Unusual Case Report

Objective. The presence of an upper airway foreign body is an emergent, potentially life-threatening situation that requires careful but rapid evaluation and management. Organic or nonorganic material may typically be found in the pyriform sinuses or tongue base or may be aspirated directly into the tracheobronchial tree. We present here an unusual case report of a patient who accidentally ingested a plastic bread clip that was lodged in his subglottis for 15 months and report successful removal in the office under local anesthesia.Methods. Mucosal anesthesia was achieved with inhaled 4% lidocaine spray. Flexible laryngoscopic removal of the foreign body was then successfully accomplished.Results. The patient’s symptoms resolved completely following removal, with no sequelae.Conclusions. Office removal of airway foreign bodies is feasible and can be safely done with adequate topical anesthesia, but great caution and emergency planning must be exercised.

scholarly journals Tracheo-oesophageal fistula in a case of button battery ingestion: CT virtual bronchoscopy imaging

2019 ◽  
Vol 12 (5) ◽  
pp. e229418
Author(s):  
Sanika Sanjeev Agarwal ◽  
Devdas Sudhakar Shetty ◽  
Manisha Vishnu Joshi ◽  
Siddhant Uttam Manwar
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Paediatric Population ◽  
Foreign Body Ingestion ◽  
Virtual Bronchoscopy ◽  
Severe Injuries ◽  
Button Battery ◽  
Non Invasive ◽  
Pass Through ◽  
Button Batteries

Foreign body ingestion in paediatric population is a very common problem. Usually the foreign bodies pass through the gastrointestinal tract without any complications; however, certain foreign bodies like button batteries might cause severe injuries like tracheo-oesophageal fistula (TOF), oesophago-aortic fistula, perforation and mediastinitis, vocal cord paralysis and stenosis after suspected perforation. In our case, an infant developed a TOF following ingestion of button battery which was diagnosed with the help of CT virtual bronchoscopy. It also contributed to the decision making regarding suitable operative techniques. Thus, CT virtual bronchoscopy can help in the diagnosis and detection of any complications due to foreign body ingestion with the added advantage of being non-invasive.

Sign in / Sign up

Export Citation Format

Share Document