Diagnosis of paediatric airway foreign body: is it easy?

Open Medicine ◽  
2014 ◽  
Vol 9 (5) ◽  
pp. 648-652
Author(s):  
Beata Rybojad ◽  
Grażyna Niedzielska ◽  
Ewa Rudnicka-Drożak

AbstractForeign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.

2010 ◽  
Vol 2010 (dec21 1) ◽  
pp. bcr0520103002-bcr0520103002 ◽  
Author(s):  
S. U. Rehman ◽  
N. Sharif ◽  
A. B. S. Zubairi

2013 ◽  
Vol 20 (6) ◽  
pp. e98-e99 ◽  
Author(s):  
Alexandra Bain ◽  
Althea Barthos ◽  
Victor Hoffstein ◽  
Jane Batt

Nonasphyxiating foreign-body aspiration in adults can be difficult to diagnose because the symptoms are nonspecific and chest x-rays may be normal due to organic composition of the foreign bodies. The diagnosis is often made via flexible bronchoscopy; however, debate remains as to whether rigid or flexible bronchoscopy is the optimal method of extraction. The authors describe a patient who was initially referred for assessment of a calcified left mainstem bronchus mass identified only on computed tomography scan of the thorax. The patient underwent flexible bronchoscopy and was discovered to have a bone fragment wedged in the bronchus for a duration of 22 years, which was successfully removed via rigid bronchoscope.


2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 69-74
Author(s):  
Danijela Dragicevic ◽  
Ljiljana Jovancevic ◽  
Rajko Jovic ◽  
Ljiljana Vlaski ◽  
Bojan Bozic

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.


2020 ◽  
Vol 5 (3) ◽  

Airway foreign bodies (AFBs) is an interdisciplinary area between, Pediatrics and Otolaryngology [1]. Foreign-body aspiration in the airway of children is a life-threatening clinical situation responsible for many deaths each year. Most airway foreign body aspirations occur in children younger than 15 years; children aged 1-3 years are the most susceptible [2]. Vegetable matter tends to be the most common airway foreign body; peanuts are the most common food item aspirated [5]. We present four interesting cases of bronchial foreign bodies that caused diagnostic and therapeutic challenges.


2002 ◽  
Vol 81 (9) ◽  
pp. 655-656 ◽  
Author(s):  
Christine B. Franzese ◽  
John M. Schweinfurth

Foreign body aspiration is a common pediatric problem that affects children of all ages, including those who are well into their adolescence. We describe the case of a 9-year old boy with an airway foreign body that had gone unrecognized for 3 months. We also review the literature on pediatric airway foreign bodies, with a focus on delayed diagnosis. A diagnosis of foreign body aspiration should be considered whenever a previously healthy child suddenly exhibits unexplained symptoms that are refractory to medical treatment and are consistent with airway obstruction.


2018 ◽  
Vol 47 (2) ◽  
pp. 164
Author(s):  
Puspa Zuleika ◽  
Abla Ghanie

Latar belakang: Aspirasi benda asing ialah masuknya benda yang berasal dari luar atau dalam tubuh, ke saluran trakeobronkial. Aspirasi benda asing saluran trakeobronkial merupakan keadaan darurat yang memerlukan tindakan bronkoskopi segera untuk mencegah komplikasi yang lebih serius. Tujuan: Mengidentifikasi karakteristik klinis pasien aspirasi benda asing saluran trakeobronkial di bagian Telinga Hidung Tenggorok – Bedah Kepala Leher (T.H.T.K.L) Fakultas Kedokteran Universitas Sriwijaya/ Rumah Sakit Dr. Mohammad Hoesin Palembang. Metode: Penelitian ini merupakan penelitian observasional deskriptif. Sampel penelitian ini diambil dari data rekam medis pasien aspirasi benda asing pada saluran trakeobronkial di Rumah Sakit Dr. Mohammad Hoesin Palembang periode Januari 2012 - Desember 2016. Hasil: Didapatkan 20 pasien dengan riwayat teraspirasi benda asing di saluran trakeobronkial. Dijumpai 9 orang laki-laki dan 11 orang perempuan dengan perbandingan 1:1,2, di mana usia 0-15 tahun merupakan penderita terbanyak aspirasi benda asing ini. Benda asing yang paling banyak ditemukan adalah mainan dan benda plastik sebanyak 9 kasus, serta jarum pentul sebanyak 6 kasus. Sebanyak 19 pasien diketahui terdapat riwayat tersedak benda asing. Pemeriksaan foto toraks menunjukkan gambaran normal pada 12 pasien. Lokasi benda asing terbanyak ditemukan di trakea sebanyak 8 kasus. Kesimpulan: Aspirasi benda asing di saluran trakeobronkial sering terjadi pada anak-anak yang berusia kurang dari 15 tahun. Benda asing terbanyak adalah anorganik berupa mainan dan benda plastik. Pemeriksaan radiologi paru dalam 24 jam pertama setelah kejadian aspirasi pada umumnya menunjukkan gambaran normal. Lokasi benda asing di saluran trakeobronkial terbanyak pada penelitian ini adalah di trakea. Kata kunci: Aspirasi, bronkoskopi, foto toraks, benda asing, traktus trakeobronkial ABSTRACT Background: Foreign body aspiration is the entrance of foreign objects from outside or inside of the body into the tracheobronchial tract. Aspiration of foreign body in tracheobronchial tract is an emergency condition that needs immediate bronchoscopy procedure to prevent serious complications. Objectives: To identify clinical characteristics of foreign body aspiration patients in ENT Department Sriwijaya Medical Faculty / Dr. Mohammad Hoesin Hospital, Palembang. Method: This study was a descriptive observational study. The sample of this study was taken from the medical record of tracheobronchial foreign body aspiration patients at Dr. Mohammad Hoesin Hospital from January 2012 until December 2016. Result: There were twenty patients with the history of foreign body aspiration in tracheobronchial tract, consisted of 9 male and 11 female, with the ratio 1:1,2, in which 0–15 year-old children were the majority of the patients. The most common foreign bodies were toys and plastic objects in 9 cases and head veil pin in 6 cases. Nineteen cases of the patients had the history of choking as presenting symptom. Chest X-Ray showed normal imaging on twelve patients. The most common site in tracheobronchial tract where foreign bodies found was the trachea, in eight cases. Conclusions: Foreign body aspirations in tracheobronchial tract were most frequently happened in children less than 15 year-old. The most common foreign bodies were anorganic material, such as toys and plastic objects. Lung X-Rays on the first 24 hours commonly showed normal imaging. Foreign bodies in tracheobronchial tracts most frequently were found in the trachea. Keywords: Aspirations, bronchoscopy, chest X-Ray, foreign body, tracheobronchial tree


2007 ◽  
Vol 14 (04) ◽  
pp. 598-601
Author(s):  
BIJAN KHADEMI ◽  
BEHROOZ GANDOMI ◽  
SEIED BASIR HASHEMI ◽  
Abdul Hamid Chohedri

Objective: To study the pattern oflaryngotracheal foreign bodies in South of Iran and to compare it with other studies.. Design: A retrospective chartreview of patients who had airway foreign body. Period : From 1991 to 2000. Setting: Department of OtolaryngologyKhalili Hospital,Shiraz,Iran. Material & Methods: Patient characteristics including age,sex, laryngobronchoscopicfindings,clinical presentations and history of foreign body aspiration were recorded .Type and site of foreign bodyaspirated was also recorded to determine the common type and site of foreign body enlodgement in this country.Results: From 1012 patients with airway foreign bodies,683 patients were male and 329 patients werefemale.Aspiration most commonly occurred in the 1-6 year age group.The most common presenting symptom wascough,dyspnea and chocking.The most common site of foreign body enlodgement was right bronchus and the mostcommon foreign bodies in our area were various types of seeds. Conclusion: Education of physicians and publicawareness are important steps needed to reduce the morbidity and mortality of foreign body aspiration.Parents shouldbe instructed to abstain from feeding nuts and seeds to young children and to keep small,potentially ingestible objectsout of their reach.


1927 ◽  
Vol 23 (11) ◽  
pp. 1145-1150
Author(s):  
G. M. Lopatin

Aspiration of foreign bodies into the windpipe usually results in respiratory damage. This lesion may be of varying intensity and may be localized in different parts of the respiratory tract or lungs. Both the intensity and the localization of the lesion may depend on a number of reasons and above all on the location of the foreign body and its type, but also on the constitutional characteristics of the body and on many other causes. Aspirated foreign bodies are found in the trachea or larynx and almost as often in the bronchi.


2020 ◽  
Vol 7 (10) ◽  
pp. 3476
Author(s):  
Washim F. Khan ◽  
Sandeep Jain ◽  
Yashwant S. Rathore ◽  
Sunil Chumber

Ingested foreign bodies usually pass uneventfully through the gastrointestinal tract but few of them can cause symptoms. They can get stuck at acute angulations or narrow part of intestine and can perforate leading to localized to generalized peritonitis, collection or abscess formation. We describe a case of 59 year old gentleman who presented with pain in right iliac fossa with fever and a hard, tender lump. Initial investigation revealed a mass in right iliac fossa adherent to anterior abdominal was in right iliac fossa region with a foreign body inside. Patient was managed with exploratory laparotomy, removal of a fish bone from cacecum and limited right hemicolectomy. Fishbone perforation of caecum is a rare entity. Careful corroboration between patient’s presentation and radiological findings with a high index of suspicion is needed for pre-operative diagnosis.


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