Prospective evaluation of tracheobronchial foreign bodies

Background: Foreign body aspiration is a condition that requires immediate and prompt management to avoid complications. Aim of this study was to find out proportion of tracheobronchial foreign bodies in under five age group, common sites of foreign body lodgement, types of tracheobronchial foreign bodies, and complications associated with this.Methods: This study was conducted in Department of ENT at Jubilee Mission Medical College and RI, Thrissur, during the period of January 2018 to June 2019 and comprises 24 cases. Rigid bronchoscopy under general anesthesia was done to remove these foreign bodies. Results: Eighteen cases were in under 5 age group. Peanut was the most common foreign body aspirated followed by badam and vegetable seeds. Common site of lodgement was in bronchi with 10 cases in right bronchi and 9 cases in left bronchi. Complication seen associated with this was pneumonia in this study.Conclusions: Foreign body aspiration is common in young children and hence a positive history might be absent. Hence there is high chance of misdiagnosis and complications. Parent education is must and avoid giving ungrinded nuts to young children.

Download Full-text

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

Gomal Journal of Medical Sciences ◽

10.46903/gjms/18.01.1949 ◽

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.

Download Full-text

Do Times until Treatment for Foreign Body Aspiration Relate to Complications?

International Journal of Otolaryngology ◽

10.1155/2016/2831614 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Walailak Tatsanakanjanakorn ◽

Surapol Suetrong

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Main Bronchus ◽

Delayed Diagnosis ◽

Foreign Body Aspiration ◽

University Hospital ◽

Age Group ◽

Common Site ◽

Plant Seeds ◽

The Right

Introduction. Foreign body aspiration is an emergency condition and may be fatal. Delayed diagnosis and treatment may be associated with complications. This study evaluated the association between time until treatment and complications due to foreign body aspiration.Methods. This study was a retrospective study conducted at Khon Kaen University Hospital, Thailand. We enrolled patients diagnosed with foreign body aspiration with evidence of foreign body detected using direct laryngobronchoscopy at any area from the larynx to the bronchus. Descriptive statistics were used to analyze the association of times of treatment with complications of foreign body aspiration.Results. During the study period, there were 43 patients that met the study criteria. The most common age group was 0–2 years. Plant seeds were the most common foreign bodies (41.9%), and the right main bronchus was the most common site (16 patients, 37.2%). There were 30 patients (69.8%) that experienced complications from foreign body aspiration. Pneumonia was the most common complication (14 patients, 32.6%). The retention time was not significantly associated with the presence of complications (pvalue: 0.366). Two patients (4.7%) died due to complete airway obstruction and prolonged hypoxia.Conclusion. Times until treatment were not significantly associated with complications from foreign body aspiration.

Download Full-text

Role of virtual bronchoscopy in children with a vegetable foreign body in the tracheobronchial tree

The Journal of Laryngology & Otology ◽

10.1017/s0022215114002837 ◽

2014 ◽

Vol 128 (12) ◽

pp. 1078-1083 ◽

Cited By ~ 15

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.

Download Full-text

Traheobronchial foreign bodies: evaluation and retrieval by rigid bronchoscopy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194925 ◽

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

Background: The foreign body aspiration is one of the commonest ENT emergencies. Delay in diagnosis and treatment may lead to significant morbidity and mortality.Methods: 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. Results: 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.Conclusions: 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.

Download Full-text

A Case of Whistle as Foreign Body in Trachea

BioScientia Medicina ◽

10.32539/bsm.v6i1.434 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1281-1286

Author(s):

Puspa Zuleika

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Pediatric Patients ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Foreign Object ◽

Case Presentation ◽

Foreign Body Extraction ◽

Tracheobronchial Foreign Body ◽

History Of

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.

Download Full-text

An Unusual Case of Foreign Body Aspiration: A Case Report

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v6i2.31593 ◽

2017 ◽

Vol 6 (2) ◽

pp. 47-49

Author(s):

Kuntal Roy ◽

Syed Khairul Amin ◽

Mumtahina Setu ◽

Tarannum Khondaker ◽

Nandita Sur Chowdhury

Keyword(s):

Case Report ◽

Foreign Body ◽

Young Children ◽

Clinical Examination ◽

Respiratory Symptoms ◽

Unusual Case ◽

Foreign Body Aspiration ◽

Delay In Diagnosis ◽

Medical College ◽

Careful History

Foreign body aspiration most commonly affects young children, with respiratory symptoms such as wheeze and cough after a choking episode. A careful history and clinical examination can identify those children that need additional investigation including bronchoscopy. However foreign body aspiration can mimic other conditions. The link between choking and subsequent symptoms may not be made by parents. We present a case with a delay in diagnosis, and discuss the appropriate management of suspected foreign body aspiration.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 47-49

Download Full-text

Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration

Journal of International Medical Research ◽

10.1177/0300060517711086 ◽

2017 ◽

Vol 45 (6) ◽

pp. 2078-2084 ◽

Cited By ~ 6

Author(s):

Aram Baram ◽

Fahmi H. Kakamad ◽

Delan Ahmed Bakir

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Main Bronchus ◽

Distinct Group ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Management Algorithm ◽

History Of ◽

Unusual Type

Background Foreign body aspiration refers to the inhalation of an object into the respiratory system and is a serious and potentially fatal event. A distinct group of patients has recently been recognized among Muslim nations. These patients include women who wear headscarves and place the safety pin in their mouth prior to securing the veils, leading to accidental foreign body aspiration. The aim of this study was to analyze the main presentation, diagnosis, treatment, and outcome of patients with scarf pin aspiration. Methods This prospective study involved patients with a history of scarf pin aspiration admitted to a single center during an 18-month period. Their main presentation, diagnosis, treatment, and outcome were analyzed. Results In total, 27 patients were included. The needle was extracted by flexible bronchoscopy in 12 (44.4%) patients, rigid bronchoscopy in 13 (48.1%), and thoracotomy in 2 (74%). One patient died during rigid bronchoscopy. All remaining 26 patients were satisfied with the postsurgical outcome at a mean follow-up of 1 week. Conclusions Scarf pin aspiration differs from other types of foreign body aspiration considering the specific population affected, and its management algorithm may thus differ from that of other foreign bodies. The left main bronchus is the most common site of pin impaction. Rigid bronchoscopy is the most commonly performed procedure for successful retrieval.

Download Full-text

Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

Medicinski pregled ◽

10.2298/mpns14s1069d ◽

2014 ◽

Vol 67 (suppl. 1) ◽

pp. 69-74

Author(s):

Danijela Dragicevic ◽

Ljiljana Jovancevic ◽

Rajko Jovic ◽

Ljiljana Vlaski ◽

Bojan Bozic

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Main Bronchus ◽

Age Groups ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Radiological Findings ◽

Tracheobronchial Foreign Body ◽

The Moment ◽

The Right

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.

Download Full-text

Panorama of foreign body in upper digestive tract in the population of Uttarakhand

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190772 ◽

2019 ◽

Vol 5 (2) ◽

pp. 416

Author(s):

Chetan Bansal ◽

Prerana Bharti ◽

V. P. Singh

Keyword(s):

Foreign Body ◽

Digestive Tract ◽

Foreign Bodies ◽

Clinical Presentation ◽

Medical Emergency ◽

Age Group ◽

Common Site ◽

Sex Type ◽

Type Site ◽

A Prospective Study

Background: Foreign body aspiration is more common in children than adults because they explore the world with their hands and mouth and also have incomplete control and immature judgment. Foreign bodies in ENT are a medical emergency as their removal demands great skill due to unpredictability in the procedure and the complications associated with it.Methods: A prospective study was conducted on 40 cases of digestive tract foreign bodies in relation to age, sex, type, site, clinical presentation, extraction and complications. Results: Youngest child was 5 months old. Most predisposed age group was 0-5 years (60% of cases). Cricopharynx (24 cases) was the most common site of impaction for foreign body. In the present study toys (22.5%) were most common foreign bodies followed by coins (15%) ingestion.Conclusions: Avoid carelessness. Avoid hasty drinking, eating, talking and running with anything in the mouth. Keep the things out of reach of the children. Be particular in sleep, anesthesia, coma or delirium. Avoid putting objects into mouth.

Download Full-text

Experiences with management of foreign body airway presenting as dire emergency

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213288 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1509

Author(s):

Aishwarya Ullal ◽

Arun P. Ajith

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Case Series ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Accidental Death ◽

Detailed History ◽

Common Causes ◽

The World ◽

To Come

Aspiration of foreign bodies by children is a common problem around the world. Foreign body aspiration is a common cause of morbidity and mortality in children, especially between ages 18 months to 3 years. Laryngeal foreign bodies pose as a dire emergency lead to choking and accidental deaths. This is a case series of five cases of laryngeal foreign bodies presenting as a dire emergency to our casualty. Detailed history and examination was done. Radiological investigations were done. Rigid bronchoscopy was performed and the foreign body was extracted restoring the airway, preventing the accidental death of the patient. Foreign bodies of the airway are the most common causes of preventable deaths among children. Quick detailed history, examination and radiological investigations are required to come to the diagnosis and prompt management. This case series throws light on how to manage laryngeal foreign bodies.

Download Full-text