scholarly journals Pill in the left bronchus-pediatric foreign body aspiration: a case report

2018 ◽  
Vol 4 (2) ◽  
pp. 600
Author(s):  
Raghul Sekar ◽  
Karthikeyan Ramasamy ◽  
Hegde Jyotirmay ◽  
Arun Alexander ◽  
Sunil Kumar Saxena
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Foreign Body ◽  
Pediatric Population ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Mortality And Morbidity ◽  
Left Bronchus

<p>Pediatric population is more prone for accidents such as foreign body aspiration. It is an important and preventable cause of mortality and morbidity in children<strong>.</strong> Pill aspiration is one of the rare causes foreign body aspiration in both children and adults. History is crucial and can guide treatment in case of foreign body aspiration. We present a 5 year old child who had history and examination suggestive of pneumonia which turned out to be a foreign body in left bronchus on computed tomography. The foreign body was a half broken tablet of Co-trimoxazole removed by rigid bronchoscopy without any complication. The child’s symptoms improved satisfactorily following removal. </p>

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 Traheobronchial foreign bodies: evaluation and retrieval by rigid bronchoscopy

2019 ◽  
Vol 5 (6) ◽  
pp. 1552
Author(s):  
Kunzes Dolma ◽  
Anchal Gupta ◽  
Apurab Gupta ◽  
Padam Singh Jamwal
Keyword(s):  
Foreign Body ◽  
Clinical Examination ◽  
Foreign Bodies ◽  
Standard Procedure ◽  
Neck Surgery ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Female Ratio ◽  
Mortality And Morbidity ◽  
Delay In Diagnosis

<p class="abstract"><strong>Background:</strong> The foreign body aspiration is one of the commonest ENT emergencies. Delay in diagnosis and treatment may lead to significant morbidity and mortality.</p><p class="abstract"><strong>Methods:</strong> The current study was conducted at Department of Otorhinolaryngology and Head and Neck Surgery, SMGS Hospital, Government Medical College, Jammu, from November 2017 to October 2018. All symptomatic patients diagnosed with foreign body aspiration on the basis of history, clinical examination and radiological evaluation and who underwent rigid bronchoscopic retrieval were included in the study. Fifty patients were studied.  </p><p class="abstract"><strong>Results:</strong> The majority of patients 33 (66%) were between 1 and 3 years of age.12 (24%) patients were over 3 years of age with oldest of 57 years old age with male: female ratio of 2.1:1. The clinical features of these patients were mainly cough, respiratory distress, wheeze, fever, stridor, choking and cyanosis. On bronchoscopy, foreign body was identified in 46 (92%) patients and no foreign body was seen in 4 (8%) patients with suspected foreign body aspiration. The most common type of foreign body was organic (73.91%), with peanuts (47.82%) being the commonest. The most common site was left bronchus seen in 22 (47.83%) patients followed by right bronchus seen in 18 (39.13%) and trachea seen in 6 (13.04%) patients. Overall mortality and morbidity rates were 2.17% and 4.35% respectively.</p><p><strong>Conclusions:</strong> History and clinical examination should be more relied upon as diagnostic tool than radiological findings in diagnosing foreign body inhalation. Rigid bronchoscopic removal of foreign body is the standard procedure for removing tracheobronchial foreign bodies. </p>

scholarly journals Diagnostic challenges in paediatric foreign body aspiration: a case report

2020 ◽  
Vol 49 (2) ◽  
Author(s):  
Inês Morais ◽  
Inês Sousa ◽  
Carolina Terra ◽  
Ana Martins ◽  
Tiago Pereira ◽  
...  
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Previous History ◽  
Bronchial Hyperresponsiveness ◽  
Clinical Signs ◽  
Paediatric Population ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Multidisciplinary Communication ◽  
History Of

Introduction: Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis. Case Report: 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed. Conclusions: A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.

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 SEX AND AGE WISE DISTRIBUTION, PRESENTATION AND SUCCESSFUL REMOVAL AND MORTALITY OF FOREIGN BODY ASPIRATION USING RIGID BRONCHOSCOPE IN CHILDREN OF DISTRICT D.I.KHAN, PAKISTAN

2020 ◽  
Vol 18 (01) ◽  
pp. 3-11
Author(s):  
Ali Khan ◽  
Mohammad Ismail Khan ◽  
Muhammad Afaq Ali ◽  
Altaf Hussain ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Foreign Body ◽  
Age Groups ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Age Group ◽  
Mortality And Morbidity ◽  
X Ray ◽  
Medical College ◽  
History Of ◽  
Successful Removal

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.

scholarly journals Prevalence of Foreign Body Aspiration in Children in a Tertiary Care Hospital

2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Kripa Dongol ◽  
Yogesh Neupane ◽  
Heempali Das Dutta ◽  
Bigyan Raj Gyawali ◽  
Bijaya Kharel
Keyword(s):  
Foreign Body ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
University Teaching ◽  
Care Hospital ◽  
Cross Sectional ◽  
Mortality And Morbidity

Introduction: Foreign body aspiration is a common problem in children with signifi cant mortality and morbidity. This study aims to determine the prevalence of foreign body aspiration in children in a tertiary care hospital of Nepal. Methods: A descriptive cross-sectional study was conducted at Tribhuvan University Teaching Hospital from April 2010 to March 2016 after obtaining ethical approval from Institutional Review Committee (Reference number- 08(6-11)E277/78). All children of age up to 15 years with suspected foreign body aspiration were included. The data was collected from the medical record section and entered in Microsoft Excel. The descriptive statistical analysis was performed. Results: A total of 26,294 patients were included in the study. The prevalence of foreign body aspiration in children was found to be 98 (0.37%). On rigid bronchoscopy, 82 patients (83.6%) were confirmed to have a foreign body in the airway. The peak incidence of foreign body aspiration was seen in patients of age group one to two years. The commonest foreign body in the airway was a peanut. Conclusions: The prevalence of foreign body aspiration in children was low, which is similar to other studies. Foreign body aspiration may lead to dreadful complications. Therefore, both the clinicians and the public need to be cautious about it.

scholarly journals Impacted denture in the left bronchus: aspiration in an awake state

2020 ◽  
Vol 6 (10) ◽  
pp. 1910
Author(s):  
Abhijit Raj ◽  
Susan K. Sebastian ◽  
Vikas Vijayan
Keyword(s):  
Foreign Body ◽  
Lower Lobe ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Left Lower Lobe ◽  
Lobe Bronchus ◽  
Partial Denture ◽  
Awake State ◽  
Left Bronchus ◽  
Tracheobronchial Foreign Body

<p class="abstract">Tracheobronchial foreign body aspiration is rare in adults. In adults it usually happens in a state of impaired alertness. We report a case of aspiration of a partial denture in an alert patient who presented with minimal symptoms. She was successfully treated with removal of the impacted denture from the left lower lobe bronchus by rigid bronchoscopy.</p>

Evaluation of computed tomography virtual bronchoscopy in paediatric tracheobronchial foreign body aspiration

2010 ◽  
Vol 124 (8) ◽  
pp. 875-879 ◽  
Author(s):  
K V Bhat ◽  
J S Hegde ◽  
U S Nagalotimath ◽  
G C Patil
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Likelihood Ratio ◽  
Chest Radiography ◽  
Foreign Bodies ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Virtual Bronchoscopy ◽  
Plain Chest ◽  
Tracheobronchial Foreign Body

AbstractObjective:Virtual bronchoscopy is a noninvasive technique which provides an intraluminal view of the tracheobronchial tree. This study aimed to evaluate this technique in comparison with rigid bronchoscopy, in paediatric patients with tracheobronchial foreign bodies undetected by plain chest radiography.Methods:Plain chest radiography was initially performed in 40 children with suspected foreign body aspiration. Computed tomography virtual bronchoscopy was performed in the 20 in whom chest radiography appeared normal. Virtual bronchoscopic images were obtained. All patients underwent rigid bronchoscopy performed by an otolaryngologist blinded to the computed tomography virtual bronchoscopy findings, within 24 hours. Virtual bronchoscopic findings were then compared with the results of rigid bronchoscopy.Results:In 12 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. In one case, a mucous plug was perceived as a foreign body on virtual bronchoscopy. In another case, a minute foreign body was missed on virtual bronchoscopy. The following parameters were calculated: sensitivity, 92.3 per cent; specificity, 85.7 per cent; validity, 90 per cent; positive likelihood ratio, 6.45; and negative likelihood ratio, 0.089.Conclusion:In the presence of a positive clinical diagnosis and negative chest radiography, computed tomography virtual bronchoscopy must be considered in all cases of tracheobronchial foreign body aspiration, in order to avoid needless rigid bronchoscopy. Computed tomography virtual bronchoscopy is particularly useful in screening cases of occult foreign body aspiration, as it has high sensitivity, specificity and validity.

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