Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience

Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients.Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed.Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention.Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

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Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience

10.21203/rs.3.rs-41995/v4 ◽

2020 ◽

Author(s):

Bo Liu ◽

Fengxia Ding ◽

Yong An ◽

Yonggang Li ◽

Zhengxia Pan ◽

...

Keyword(s):

Foreign Body ◽

Medical Records ◽

Foreign Bodies ◽

Pediatric Patients ◽

Previous History ◽

Rigid Bronchoscopy ◽

Diagnostic Difficulties ◽

History Of ◽

Male Patients ◽

Symptoms And Signs

Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

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Occult foreign body aspirations in pediatric patients: 20-years of experience

BMC Pulmonary Medicine ◽

10.1186/s12890-020-01356-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Bo Liu ◽

Fengxia Ding ◽

Yong An ◽

Yonggang Li ◽

Zhengxia Pan ◽

...

Keyword(s):

Foreign Body ◽

Medical Records ◽

Foreign Bodies ◽

Pediatric Patients ◽

Previous History ◽

Rigid Bronchoscopy ◽

Diagnostic Difficulties ◽

History Of ◽

Male Patients ◽

Symptoms And Signs

Abstract Background The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n = 25, 71.4%). Coughing (n = 35, 100%) and wheezing (n = 18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n = 10) and the most common inorganic foreign bodies were pen caps (n = 5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

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Occult Foreign Body Aspirations in Pediatric Patients: 20-years of Experience

10.21203/rs.3.rs-41995/v1 ◽

2020 ◽

Author(s):

Bo Liu ◽

Fengxia Ding ◽

Yong An ◽

Zhengxia Pan ◽

Gang Wang ◽

...

Keyword(s):

Foreign Body ◽

Medical Records ◽

Foreign Bodies ◽

Pediatric Patients ◽

Previous History ◽

Rigid Bronchoscopy ◽

Diagnostic Difficulties ◽

History Of ◽

Male Patients ◽

Symptoms And Signs

Abstract Background: The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients. Methods: Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed. Results: Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n=25, 71.4%). Coughing (n=35, 100%) and wheezing (n=18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n=10) and the most common inorganic foreign bodies were pen caps (n=5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention. Conclusions: Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.

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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.

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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.

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Diagnostic challenges in paediatric foreign body aspiration: a case report

Colombian Journal of Anesthesiology ◽

10.5554/22562087.e919 ◽

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.

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ROLE OF RIGID BRONCHOSCOPY IN MANAGEMENT OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION

Journal of Medical Sciences ◽

10.52764/jms.20.28.4.8 ◽

2020 ◽

Vol 28 (4) ◽

pp. 345-347

Author(s):

Israr ud Din ◽

Muhammad Hafeez ◽

Muhammad Junaid ◽

Arif Raza Khan ◽

Imran Khan

Keyword(s):

Foreign Body ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Foreign Body Bronchus ◽

Number Of Patients ◽

Tracheobronchial Foreign Body ◽

History Of ◽

Male Patients ◽

One Year

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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Successful Removal of a Chronic Aspirated Foreign Body after Twelve Years

Case Reports in Pulmonology ◽

10.1155/2018/8241591 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Radhika Z. Reddy ◽

Yvonne M. Carter ◽

David W. Hsia

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Rigid Bronchoscopy ◽

Tissue Reaction ◽

Radiographic Evaluation ◽

Mainstem Bronchus ◽

Left Mainstem ◽

History Of ◽

Successful Removal ◽

Chronic Pneumonia

Chronic retention of aspirated foreign bodies is rare but can result in indolent systemic and respiratory symptoms. Bronchoscopy may show features of tissue reaction to the foreign body, including granulation tissue, endobronchial stenosis, strictures, edema, and airway distortion. The diagnosis of foreign body aspiration is often difficult to establish since some patients may not give a clear history of aspiration or may present late. In addition, patients may be misdiagnosed with chronic pneumonia, bronchitis, asthma, or malignancy. We present the case of a 42-year-old male who had a chronically retained piece of an aluminum beverage container in the left mainstem bronchus for 12 years. Careful history, radiographic evaluation, and bronchoscopic examination revealed the foreign body, which was successfully extracted by rigid bronchoscopy.

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Management of oesophageal foreign bodies in pediatric patients: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212454 ◽

2021 ◽

Vol 7 (7) ◽

pp. 1164

Author(s):

Manit M. Mandal ◽

Ajay J. Panchal ◽

Rakesh Kumar ◽

Parth B. Kapadia ◽

Vipul Valiya ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Pediatric Patients ◽

Demographic Data ◽

Complete Recovery ◽

Clinical Problem ◽

Tertiary Hospital ◽

Battery Cell ◽

Presenting Symptoms ◽

History Of

Background: Amongst pediatric patients, oesophageal foreign bodies (OFBs) are relatively common clinical problem. Majority pass harmlessly through gastrointestinal tract, some can cause complications or morbidities. Our study considered and reviewed our experience in managing OFBs in pediatric patients, with emphasis on the management and outcomes of complicated cases.Methods: 77 cases of OFBs (diagnosis established), upto 12 years of age admitted at our tertiary hospital between January 2015 to December 2020 (duration of 6 years) were reviewed and analysed. On the basis of our analysis accounting demographic data, presenting symptoms, workup investigation, management, complications and outcomes, results and conclusions were derived.Results: Amongst cases, 43 were male and 34 female. Mean age for our cases was 5.4 years. 56 cases (72.7%) cases presented in the hospital within first 24 hours. Commonest foreign body found in 64 cases (83.1%) was coin. Most cases had history of witnessed ingestion. Commonest presentation was asymptomatic (with history of witnessed ingestion), followed by complaint of vomiting and drooling of saliva. Most patients were discharged within 48 hours post-operatively except for 2 patients who presented intra-operatively with edematous inflamed mucosa with slight charring on oesophagoscopy where foreign body was button battery (cell). Follow-up period ranged from 2 to 8 months and all patients had complete recovery without any sequelae.Conclusions: Our experience of 6 years with 77 pediatric patients with OFBs having various presentations have been reviewed, analysed and concluded here. All the patients had complete recovery without any sequelae.

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