scholarly journals Foreign body extraction through the rigid bronchoscopy

2011 ◽  
Vol 68 (10) ◽  
pp. 878-880 ◽  
Author(s):  
Stanko Mrvic ◽  
Milos Milosavljevic ◽  
Dragan Stojkovic ◽  
Slobodan Milisavljevic ◽  
Dragce Radovanovic ◽  
...  

Introduction. Foreign body aspiration into tracheobronchial tree represents an urgent condition at high level of risk. Etiology is different, and this condition is typical for all ages with highest incidence in pediatric population. Case report. A successful foreign body removal (partial denture) in a 34-year old man was presented. Radiography and computerized tomography of the chest showed a foreign body localized at the level of the right bronchus including the right middle lobe bronchus. By the use of rigid bronchoscopy, a foreign body was visualized and mobilized from the segmental bronchus in the first act, and then completely extracted. Conclusion. Efficient diagnostics and extraction are imperative for the aspirated foreign body preventing life-threatening complications.

2020 ◽  
Vol 3 (1) ◽  
pp. 323-325
Author(s):  
Prajwol Shrestha ◽  
Ashesh Dhungana ◽  
Madhusudan Kayastha ◽  
Manisha Shrestha ◽  
Deepa Niroula

Foreign body aspiration is common in children and adolescents. Foreign body aspiration is often unnoticed and diagnosis may be delayed in children, as many fail to provide a history. Although rigid bronchoscopy is preferred modality, flexible bronchoscopy is also a useful tool for foreign body extraction from the distal airways in selected cases. An eleven-year-old boy presented with a history of fever and dry cough of one month's duration. A chest x-ray showed a linear radiopaque foreign body along the course of the right bronchus. Flexible bronchoscopy revealed a metallic nail-like structure in right lower lobe bronchus which was successfully grasped with the flexible forceps and extracted via the oral route with the bronchoscope. Upon extraction aspirated foreign body was found to be a push-pin.


Author(s):  
Anastasios-Panagiotis Chantzaras ◽  
Panagiota Panagiotou ◽  
Spyridon Karageorgos ◽  
Konstantinos Douros

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.


2019 ◽  
Vol 7 (1) ◽  
pp. 94 ◽  
Author(s):  
Sivakumar E. ◽  
Ramasubramaniam P.

Background: Foreign Body (FB) aspiration is a life-threatening problem in children. Here the demographic pattern, clinical presentation, type of Foreign Body (FB) and outcome of FB aspiration was examined.Methods: An observational case series study done in Institute of child health and research centre, Government Rajaji hospital, Madurai during November 2015 to June 2018. After a detailed history and clinical examination, children with definite evidence of FB in tracheobronchial tree were subjected to rigid bronchoscopy and with doubtful evidence were subject to FFBS. They were followed up for complications.Results: Of the 136 children, 86.03% (n=117) were under 3 years of age. A positive history of FB aspiration was present only in 51.4% (n=70). Unilateral hyperinflation was seen in 48.53% (n=66) but was normal in 13.97% (n=19). Flexible Fiber Optic Bronchoscopy (FFBS) diagnosed FBs in 61.02% (n=83) which included children with acute onset breathlessness and persistent radiological features. Peanut was the most common FB 64.71% (n=44). FBs were found in the right side in 50% (n=34) and in the left in 38.2% (n=26).  36% (n=49) developed complications due to the FBs and 2.9% (n=4) due to procedure.Conclusions: FB aspiration is most common in children less than 3 years of age. Positive history of aspiration was seen in only 51.4% and chest X-ray was normal in 13.97%. FFBS diagnosed FB in 61.02%. Peanut was the most common FB. Persistent pneumonitis is the most common complication.


1983 ◽  
Vol 92 (4) ◽  
pp. 387-390 ◽  
Author(s):  
Norman T. Berlinger ◽  
John Foker ◽  
Charles Long ◽  
Russell V. Lucas

Children with acyanotic congenital heart disease frequently develop respiratory difficulties such as atelectasis, pneumonia, or infantile lobar emphysema. In some cases, the cause of the respiratory difficulty is compression of the tracheobronchial tree by hypertensive dilated pulmonary arteries, since this type of heart disease frequently demonstrates large left-to-right intracardiac shunts. Sites of predilection for compression include the left main bronchus, the left upper lobe bronchus, the junction of the right bronchus intermedius and right middle lobe bronchus, and the left side of the distal trachea. Cardiac anomalies which predispose to this type of compression include ventricular septal defect, patent ductus arteriosus, interruption of the aortic arch, and tetralogy of Fallot. Pulmonary arteriopexy may relieve the tracheobronchial compression.


Author(s):  
Francisco Alves De Sousa ◽  
Ana Costa Silva ◽  
Ana Nóbrega Pinto ◽  
Cecília Almeida E. Sousa

<p>Foreign body sensation is a common complaint in the otorhinolaryngology emergency. Careful examination of the patient’s pharynx is mandatory, but sometimes the object is not visualized. In such scenario, it may be important to explore signs and symptoms indicating lower aerodigestive impaction. This work describes the case of a 73-year-old woman without relevant comorbidities attending to emergency care. She complained of a foreign body sensation on the right side of the throat after ingesting a meal, which motivated referral to otorhinolaryngology. Flexible transnasal nasopharyngoscopy was unremarkable and no foreign bodies were found. Auscultation was performed revealing low-pitch expiratory wheezing on her right hemithorax. The suspicion of bronchial foreign body was then raised, which was ultimately confirmed by imaging and bronchoscopy, showing an impacted pea on the right lower lobe bronchus. The stethoscope was hence determinant for detecting aspiration, by revealing consistent alterations. Its usage should be encouraged in similar scenarios, highlighting the role of this classic but sometimes forgotten tool. Importantly, higher neck/throat sensations should not exclude the possibility of a lower airway foreign body.</p>


2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Ratna Priya ◽  
Sheetal Shelke ◽  
Kartik Krishnan

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.


2014 ◽  
Vol 128 (12) ◽  
pp. 1078-1083 ◽  
Author(s):  
G Behera ◽  
N Tripathy ◽  
Y K Maru ◽  
R K Mundra ◽  
Y Gupta ◽  
...  

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.


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.


Author(s):  
Yassine Baiz ◽  
Oussama Abdessalam Afandi ◽  
Hicham Fenane ◽  
Yassine Msougar

This patient is a 24-year-old student by profession and from a non-consanguineous marriage, 2nd of a sibship of 4, originally and resident in Marrakech of low socioeconomic level, having as antecedent an inhalation of a neglected metallic foreign body at the age of 2 years, which presents itself for chronic bronchorrhea which has been evolving for 5 years and of recurrent pulmonary infection with the notion of a false route during swallowing which appeared 6 months ago, in who underwent pleuropulmonary examination noted the presence of right basithoracic snoring rattles, thoracic CT and bronchial fibroscopy demonstrated a metallic foreign body at the level of the right bronchus strain with dilatation of the cylindrical type sequential bronchi interesting the associated middle lobe to an oesotracheal fistula of supracarinary topography. preoperative preparation with antibiotic therapy and bronchial drainage respiratory physiotherapy and a decision on thoracic surgical intervention with left selective intubation was taken and right posterolateral thoracotomy was performed with spotting and extraction of the foreign body by bronchotomy with dissection and liberation of the margins fistula and padding of the oesotracheal fistula, the postoperative follow-up was simple and the course in the course, medium and long term was marked by a good clinical, biological and radiological improvement with a decline of 14 months.


2020 ◽  
Vol 28 (6) ◽  
pp. 658-662
Author(s):  
Ae Ri An ◽  
Seung Yong Park ◽  
Jong Hun Kim ◽  
Kum Ju Chae ◽  
Myoung Ja Chung

Mixed squamous and glandular papilloma (mixed papilloma) of the lung has been reported in fewer than 25 cases in the English literature. Although it is known as a benign tumor, malignant transformation has been reported. Papillary cystic carcinoma is characterized by papillary and cystic growth patterns and has been reported as a subtype of adenocarcinoma, mainly in the salivary glands, breast, and pancreas. In this article, we report a case of adenocarcinoma-papillary cystic pattern arising from mixed papilloma of the lung in a 76-year-old male patient. Chest computed tomography scan revealed an endobronchial mass growing at the right medial segmental bronchus. Middle lobe lobectomy was performed, revealing a 4.9 × 1.9 cm-sized mass that protruded into the bronchus. Microscopically, the tumor showed numerous cysts lined by micropapillary projections. The tumor cells had round and vesicular nuclei with prominent nucleoli, and mitosis was frequent. A limited portion of the tumor consisted of benign mixed papilloma. The tumor showed diffuse immunoreactivity for thyroid transcription factor-1 and strong expression of p16. We investigated the mutational status of cancer-related genes using targeted next-generation sequencing and identified a genetic alteration in the BRAF gene. This is the first case report of papillary cystic carcinoma arising in mixed papilloma of the lung.


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