Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

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.

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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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Tracheobronchial Foreign Body Aspiration: Dental Prosthesis

Case Reports in Pulmonology ◽

10.1155/2014/465856 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Ataman Köse ◽

Dilek Kostak ◽

Erol Aramagan ◽

Aslıhan Durak ◽

Nur Sezin Seçkin ◽

...

Keyword(s):

Foreign Body ◽

Signs And Symptoms ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Dental Prosthesis ◽

Tracheobronchial Foreign Body ◽

Bronchial System ◽

Foreign Materials ◽

Dental Apparatus ◽

The Right

It is important to extract foreign bodies for avoiding life-threatening complications. They can lead to death if they are not treated. Different signs and symptoms could occur according to the complete or partial airway obstruction. Foreign body aspiration is a rare incident in adults. The organic foreign materials such as foods are found to be aspirated more commonly and are usually settled in the right bronchial system. However, dental prosthesis and teeth aspirations are rare in literature. In our study, a 52-year-old male patient who had aspirated the front part of his lower dental prosthesis accidentally is presented and the foreign body is extracted by using rigid bronchoscopy. There are many causes of aspiration but dental prosthetic aspirations should be kept in mind during sleep. For this reason, dental apparatus must be taken out while asleep.

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Rigid Bronchoscopy in Foreign Body Aspiration Diagnosis and Treatment in Children

Children ◽

10.3390/children8121206 ◽

2021 ◽

Vol 8 (12) ◽

pp. 1206

Author(s):

Aleksandra Pietraś ◽

Marcin Markiewicz ◽

Grażyna Mielnik-Niedzielska

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Main Bronchus ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

Diagnosis And Treatment ◽

Common Condition ◽

Pediatric Otolaryngology ◽

Foreign Body Extraction ◽

Medical University

Foreign body aspiration in children is a common condition and can bring about serious undesired results. Fast and accurate diagnosis and foreign body extraction from airways are essential. We performed a retrospective study on rigid bronchoscopy outcomes due to suspected foreign body aspiration. A total of 66 children were admitted to the Chair and Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin between 2015 and 2020 and underwent rigid bronchoscopy in general anesthesia due to suspected foreign body aspiration. We analyzed the data, including patients age and sex, reported complaints, and bronchoscopy findings. Analyzed children were aged from 8 months to 17 years old; 74.24% of them were under 3 years old during the procedure, and most of the operated patients were males. In 36.36% cases, no foreign body was identified, and 57.14% foreign bodies were located in right main bronchus. A total of 80.95% of foreign bodies extracted from airways were organic, mostly nuts. Diagnosis and treatment of suspected foreign body aspiration requires consistent cooperation between pediatricians, pulmonologists, anesthesiologists, and otolaryngologists.

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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.

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Our Anesthesia Experiences in the Tracheobronchial Foreign Body Aspirations of Pediatric Patients During Rigid Bronchoscopy

Journal of Cardio-Vascular-Thoracic Anaesthesia and Intensive Care Society ◽

10.5222/gkdad.2021.31032 ◽

2021 ◽

Author(s):

Yiğit Şahin ◽

Tülay Çardaközü ◽

Hüseyin Fatih Sezer

Keyword(s):

Foreign Body ◽

General Anesthesia ◽

Similar Rate ◽

Rigid Bronchoscopy ◽

Muscle Relaxants ◽

Foreign Body Aspiration ◽

Anesthesia Induction ◽

Inhalation Anesthetics ◽

Tracheobronchial Foreign Body ◽

The Right

Objective: Bronchoscopy is the gold standard in the diagnosis and treatment of tracheobronchial foreign body aspiration (TBFBA) in children. Rigid bronchoscopy (RB) under general anesthesia is generally preferred in children. In this article, our anesthesia experiences during rigid bronchoscopy performed for tracheobronchial foreign body aspiration and removal of foreign bodies in children are shared. Methods: The medical records of all patients aged between 0-18 years who underwent RB under general anesthesia due to suspicion of TBFBA between January 1, 2014 and December 31, 2018 were retrospectively analyzed. Results: TBFBA was more common in boys and organic foreign body aspiration was significantly higher in patients between 13-36 months of age. Patients most frequently presented with cough and wheezing. Most of them were operated between 8 am and 4 pm. TFBs were localized in the right and left main bronchi at a similar rate. Anesthesia induction was usually achieved with iv. propofol, total intravenous anesthesia and sevoflurane inhalation was administered for maintenance of anesthesia. Except for proximally located TBFBs, intermediate-or short-acting muscle relaxants were applied to most of the cases depending on the duration of the procedure. Three patients were intubated postoperatively and transferred to intensive care unit. Respiratory distress responded to medical treatment in 25 patients. No cardiac arrest or death occurred during the procedure. Conclusion: RB and anesthesia procedure for TBYCA requires experience. There is no clear recommendation about premedication, the use of muscle relaxants should be evaluated according to the localization of TBYC. In anesthesia management, intravenous or inhalation anesthetics can be used.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215110000769 ◽

2010 ◽

Vol 124 (8) ◽

pp. 875-879 ◽

Cited By ~ 29

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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Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors

BMC Surgery ◽

10.1186/s12893-021-01089-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weigang Gan ◽

Ning Xiao ◽

Yiyuan Feng ◽

Danmei Zhou ◽

Juanjuan Hu ◽

...

Keyword(s):

Foreign Body ◽

Pediatric Patients ◽

Treatment Delay ◽

Rigid Bronchoscopy ◽

Foreign Body Aspiration ◽

External Factors ◽

Factors Affecting ◽

Intrinsic Factors ◽

Common Location ◽

Tracheobronchial Foreign Body

Abstract Background Tracheobronchial foreign body aspiration (TFBA) is a critical disease in children and is extremely dangerous, even life-threatening. The factors affecting the occurrence and prognosis of TFBA are complex. The purpose of this study is to examine the external and intrinsic factors affecting clinical features of TFBA in West China and propose potential effective intervention measures. Methods We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA with foreign bodies (FBs) removed by rigid bronchoscopy under general anesthesia at the otolaryngology department from December 2017 to November 2018. The data included age, sex, clinical symptoms, type and location of FB, guardians, prehospital duration and residence of these pediatric patients. Results The ratio of males (72) to females (53) was 1.4:1. Children aged from 1 to 3 years accounted for 76% (95/125) of patients. Cough, continuous fever and dyspnea were the primary symptoms. The right primary bronchus was the most common location of FB detection by rigid bronchoscopy (67 cases, 53.6%). Organic FBs were most common in our study. Guardians of patients significantly differed in the rural (parents 16, grandparents 31) and urban (parents 52, grandparents 26) groups (χ2 = 12.583, p = 0.000). More children in the rural group than in the urban group had a treatment delay longer than 72 h. More children in the group with no history of FB aspiration (12, 25%) than in the group with prior FB aspiration had a treatment delay longer than 72 h. Conclusion Pediatric TFBA is a common emergency in otolaryngology. Age, sex, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FB species and prehospital time were defined as external factors of TFBA. External and intrinsic factors both influence the occurrence and progression of TFBA. It is extremely important to take effective measures to control external factors, which can decrease morbidity and mortality.

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Challenges in Management of Tracheobronchial Foreign Bodies with Delayed Presentation: An Institutional Experience

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718964 ◽

2021 ◽

Author(s):

Darwin Kaushal ◽

Amit Goyal ◽

Kapil Soni ◽

Bikram Choudhury ◽

Nithin Prakasan Nair ◽

...

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Preoperative Planning ◽

Rigid Bronchoscopy ◽

Delayed Presentation ◽

Betel Nut ◽

Key Factors ◽

Tracheobronchial Foreign Body ◽

Institutional Experience ◽

Definitive Management

Abstract Introduction Airway foreign bodies are emergencies involving multidisciplinary departments like Pediatrics, Aneasthesiology and Otorhinolaryngology. It is always a challenge to diagnose and manage patients who present late to our emergencies. Objective In the present study, we aim to analyze the various challenges faced during the management of tracheobronchial foreign bodies with delayed presentation. Methods A retrospective hospital record-based analysis of patients who presented to us with tracheobronchial foreign bodies from January 2017 to February 2020 was performed. All patients until the age of 16 years old were included in the present study. We assessed the demographics, preoperative, intraoperative and postoperative data of the patients. Results Seventeen patients were analyzed in the study. Among these, 44.4% of the patients had delayed presentation (> 1 month). The majority of the patients had an organic foreign body (Supari or betel nut). All patients underwent rigid bronchoscopy, followed by optical forceps-assisted removal of the foreign body. A total of 82% of the patients had granulations around the foreign body. Conclusion Management of delayed presentation tracheobronchial foreign body is a big challenge for Otorhinolaryngologists. The key factors for preventing complications in the definitive management of tracheobronchial foreign bodies are preoperative planning, multi-discipline teamwork, surgeon expertise and technique.

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