scholarly journals Unusual case of nail in lung

2017 ◽  
Vol 4 (6) ◽  
pp. 1709
Author(s):  
Ashok P. Arbat ◽  
Sameer A. Arbat ◽  
Meenakshi S. Ghadge ◽  
Jayshree J. Upadhye

Tracheobronchial foreign body aspiration is a health problem that can be seen in all age groups, and it requires urgent diagnosis and intervention. We report an unusual case of nail in lung. 45 years old male was referred to us with history of aspiration of nail 2 Days back and cough. X-ray Chest PA view showed radio-opaque foreign body in right lung-lower zone. Patient had undergone bronchoscopy 2 days ago with report stating, “Normal study; No foreign body Seen” Counselling of the patient and relatives was done. Informed consent was taken. Under general anaesthesia with intubation, fluoroscopy guided video bronchoscopy was performed with external diameter 5.6mm and working channel 2mm. Foreign body was localized and removed It’s an innovative technique with multi-disciplinary approach. Counselling of the patient and relatives is important. 

2020 ◽  
Vol 18 (01) ◽  
pp. 3-11
Author(s):  
Ali Khan ◽  
Mohammad Ismail Khan ◽  
Muhammad Afaq Ali ◽  
Altaf Hussain ◽  
Muhammad Ibrahim ◽  
...  

Background: Foreign body aspiration commonly occurs in young children and is associated with high degree of mortality and morbidity. The objectives of this study were to determine epidemiologic, clinical and endoscopic perspectives of foreign body aspiration in children of District D.I.Khan, Pakistan. Materials & Methods: This descriptive study was conducted in Department of ENT, Gomal Medical College/ DHQ Teaching Hospital, D.I.Khan, Pakistan from November 2017-April 2019. 105 children with suspected foreign body (FB) aspiration were included. All patients underwent rigid bronchoscopy under GA. After check X-ray and one day observation, they were discharged. Variables were sex, age in years and age groups, successful removal, mortality, history of FB aspiration, cough, wheezing, choking, stridor, reduced air entry and location of FB. Age in years was numeric, age groups ordinal and all other variables were on nominal scale. Age in years was described by mean & SD and others by count and percentage. Results: The sample with suspected foreign body aspiration (n=105) included 61 (58.1%) boys and 44 (41.9%) girls, with 20 (19.05%) in age group 0-2.0 years, 58 (55.24%) 2.0-5.0 years and 27 (25.71%) 5.0-14 years. Chest X-Ray was done in 98/105 (93.33%) cases. Frequency of successful FB removal by rigid bronchoscopy was 86/105 (81.90%). Mortality was none. Out of 86 confirmed cases, 51 (59.30%) were boys and 35 (40.70%) girls, with 19 (22.10%) in age group 0-2.0 years, 55 (63.95%) 2.0-5.0 years and 12 (13.95%) 5.0-14 years. Mean age was 3.57±1.78. History of FB aspiration was in 75/86 (87.21%), cough 65 (75.58%), stridor 14 (16.28%), wheezing 54 (62.79%) and choking 28 (32.56%) cases. Reduced air entry was 44 (51.16%) on right side, 17 (19.77%) on left side and 25 (29.05%) bilateral. Location of FB was larynx 6 (9.98%), trachea 20 (23.26%), right bronchus 44 (51.16%) and left bronchus 16 (18.60%). Conclusions: Foreign body aspiration in children in not an uncommon event. The parents should try to prevent such event, and if there, should present the child to emergency department of a hospital. ENT surgeons are supposed to evaluate and plan an earlier intervention as rigid bronchoscopy for these children.


2018 ◽  
Vol 47 (2) ◽  
pp. 164
Author(s):  
Puspa Zuleika ◽  
Abla Ghanie

Latar belakang: Aspirasi benda asing ialah masuknya benda yang berasal dari luar atau dalam tubuh, ke saluran trakeobronkial. Aspirasi benda asing saluran trakeobronkial merupakan keadaan darurat yang memerlukan tindakan bronkoskopi segera untuk mencegah komplikasi yang lebih serius. Tujuan: Mengidentifikasi karakteristik klinis pasien aspirasi benda asing saluran trakeobronkial di bagian Telinga Hidung Tenggorok – Bedah Kepala Leher (T.H.T.K.L) Fakultas Kedokteran Universitas Sriwijaya/ Rumah Sakit Dr. Mohammad Hoesin Palembang. Metode: Penelitian ini merupakan penelitian observasional deskriptif. Sampel penelitian ini diambil dari data rekam medis pasien aspirasi benda asing pada saluran trakeobronkial di Rumah Sakit Dr. Mohammad Hoesin Palembang periode Januari 2012 - Desember 2016. Hasil: Didapatkan 20 pasien dengan riwayat teraspirasi benda asing di saluran trakeobronkial. Dijumpai 9 orang laki-laki dan 11 orang perempuan dengan perbandingan 1:1,2, di mana usia 0-15 tahun merupakan penderita terbanyak aspirasi benda asing ini. Benda asing yang paling banyak ditemukan adalah mainan dan benda plastik sebanyak 9 kasus, serta jarum pentul sebanyak 6 kasus. Sebanyak 19 pasien diketahui terdapat riwayat tersedak benda asing. Pemeriksaan foto toraks menunjukkan gambaran normal pada 12 pasien. Lokasi benda asing terbanyak ditemukan di trakea sebanyak 8 kasus. Kesimpulan: Aspirasi benda asing di saluran trakeobronkial sering terjadi pada anak-anak yang berusia kurang dari 15 tahun. Benda asing terbanyak adalah anorganik berupa mainan dan benda plastik. Pemeriksaan radiologi paru dalam 24 jam pertama setelah kejadian aspirasi pada umumnya menunjukkan gambaran normal. Lokasi benda asing di saluran trakeobronkial terbanyak pada penelitian ini adalah di trakea. Kata kunci: Aspirasi, bronkoskopi, foto toraks, benda asing, traktus trakeobronkial ABSTRACT Background: Foreign body aspiration is the entrance of foreign objects from outside or inside of the body into the tracheobronchial tract. Aspiration of foreign body in tracheobronchial tract is an emergency condition that needs immediate bronchoscopy procedure to prevent serious complications. Objectives: To identify clinical characteristics of foreign body aspiration patients in ENT Department Sriwijaya Medical Faculty / Dr. Mohammad Hoesin Hospital, Palembang. Method: This study was a descriptive observational study. The sample of this study was taken from the medical record of tracheobronchial foreign body aspiration patients at Dr. Mohammad Hoesin Hospital from January 2012 until December 2016. Result: There were twenty patients with the history of foreign body aspiration in tracheobronchial tract, consisted of 9 male and 11 female, with the ratio 1:1,2, in which 0–15 year-old children were the majority of the patients. The most common foreign bodies were toys and plastic objects in 9 cases and head veil pin in 6 cases. Nineteen cases of the patients had the history of choking as presenting symptom. Chest X-Ray showed normal imaging on twelve patients. The most common site in tracheobronchial tract where foreign bodies found was the trachea, in eight cases. Conclusions: Foreign body aspirations in tracheobronchial tract were most frequently happened in children less than 15 year-old. The most common foreign bodies were anorganic material, such as toys and plastic objects. Lung X-Rays on the first 24 hours commonly showed normal imaging. Foreign bodies in tracheobronchial tracts most frequently were found in the trachea. Keywords: Aspirations, bronchoscopy, chest X-Ray, foreign body, tracheobronchial tree


2019 ◽  
Vol 99 (1) ◽  
pp. 47-51 ◽  
Author(s):  
Shorook Na’ara ◽  
Igor Vainer ◽  
Moran Amit ◽  
Arie Gordin

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.


2015 ◽  
Vol 10 (5) ◽  
pp. 666-670 ◽  
Author(s):  
Yi-Lan Sun ◽  
Zhang Bao ◽  
Xue-Fen Wang ◽  
Li-Hong Wang ◽  
Jian-Ying Zhou

2018 ◽  
Vol 4 (2) ◽  
pp. 45
Author(s):  
Isnu Pradjoko ◽  
Chandra Jaya

Background: Aspiration of a tracheobronchial foreign body is a serious and fatal event. Progress in terms of prevention, first aid, and endoscopic technology, caused a decline of almost 20% of deaths from foreign body aspiration that occurred in the United States. Statistically, the percentage of foreign body aspirations based on their respective location is: 5% hypopharynx, 12% larynx-trachea, and 83% bronchus. Most cases of foreign body aspiration occur in children aged <15 years old; about 75% of foreign body aspirations occur in children aged 1-3 years. The female-to-male ratio is 1.4:1. Case: A 11-year-old boy swallowed needles while playing flashlight about 2 hours before coming to Pulmonary Emergency Room of Dr. Soetomo General Hospital. Discussion: Chest X-ray examination found a shadow of metal density projected in the right lung. Fiber optic bronchoscopy (FOB) was performed for diagnostic and therapeutic indication to see the presence of a foreign body in the airway and remove the foreign body, but failed. When the needle was extracted, the patient coughed that the needle bounces to the supramaxilla area. FOB with nasal cavity approach successfully extracted the corpus alienum. Conclusion: Corpus alienum of airway sometimes is difficult to extract. FOB with nasal cavity approach can be done to manage corpus alienum in the upper airway that moved from lower airway when FOB was performed.


2021 ◽  
Vol 6 (1) ◽  
pp. 1281-1286
Author(s):  
Puspa Zuleika

Background. Most of foreign body aspiration cases are found in children under the age of fifteen. Pediatric patients often presents with non-food foreign body aspiration, such as toys. The most common clinical manifestation are history of choking following foreign object insertion into the mouth (85%), paroxysmal cough (59%), wheezing (57%) and airway obstruction (5%). Case presentation. Main principle of airway foreign body extraction is to do it immediately in the most optimal condition with slightest possible trauma. Rigid bronchoscopy is a suitable choice for tracheal foreign body extraction. We reported a case of seven years old male with tracheal foreign body presented with history of whistle ingestion five hours prior to admission. This patient was discharged from hospital after third days of rigid bronchoscopy procedure. Conclusion. History of foreign body aspiration in children should be suspected as a tracheobronchial foreign body. Rigid bronchoscopy is preferred to extract foreign bodies present in the trachea. The prognosis for tracheobronchial foreign body aspiration is good if the foreign body is treated early and without complications.


2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 69-74
Author(s):  
Danijela Dragicevic ◽  
Ljiljana Jovancevic ◽  
Rajko Jovic ◽  
Ljiljana Vlaski ◽  
Bojan Bozic

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.


2013 ◽  
Vol 12 (4) ◽  
pp. 449-452
Author(s):  
SBA Rahim ◽  
T Maruthamuthu ◽  
LL Chooi ◽  
A Singh ◽  
MRBM Yunus

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


2020 ◽  
Vol 28 (4) ◽  
pp. 345-347
Author(s):  
Israr ud Din ◽  
Muhammad Hafeez ◽  
Muhammad Junaid ◽  
Arif Raza Khan ◽  
Imran Khan

Objective: To determine the role of Rigid Bronchoscopy in Management of Tracheobronchial Foreign Body Aspiration. Material and Methods: This study was conducted in otolaryngology department, Khyber teaching hospital, Peshawar of one year duration from January 2018 to December 2019. Total 90 Patients of age 4 months to 14 years on clinical suspicion of foreign body bronchus were included, while patients with history of bronchial asthma, pulmonary tuberculosis and radio opaque foreign body bronchus were excluded. Results: Total number of patients was 90 in which male patients were 60 (66.67 %) and female patients were 30 (33.33 %), patients with foreign body bronchus were 80 (88.89%). Male patients with foreign body bronchus was 53 (58.89%) and female 27 (30.00%). In age range from 4 months to 3 years, 35(39%) Patients underwent bronchoscopy in which foreign body bronchus retrieved in 30(37.5%) patients. Conclusion: Patients with history of repeated chest infection, relieved by medicines for some time should not be over look, as vegetative foreign body bronchus are radiolucent and patients usually present late in respiratory compromised state, the clinician must urge, for prompt treatment as rigid bronchoscopy.


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