scholarly journals Rigid Bronchoscopy in Foreign Body Aspiration Diagnosis and Treatment in Children

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1206
Author(s):  
Aleksandra Pietraś ◽  
Marcin Markiewicz ◽  
Grażyna Mielnik-Niedzielska

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.

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.


2017 ◽  
Vol 45 (6) ◽  
pp. 2078-2084 ◽  
Author(s):  
Aram Baram ◽  
Fahmi H. Kakamad ◽  
Delan Ahmed Bakir

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.


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.


2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Novialdi Novialdi ◽  
Fachzi Fitri ◽  
Histawara Subroto

Abstrak Aspirasi benda asing bronkus adalah masalah yang sering  pada anak-anak dan merupakan masalah seriusserta bisa berakibat fatal. Sebagian besar aspirasi benda asing di bronkus pada anak-anak karena kecenderunganmemasukkan sesuatu ke mulut, pertumbuhan gigi molar yang belum lengkap, kurangnya pengawasan dari orang tuadan lain-lain. Aspirasi jarum pentul di bronkus biasanya terjadi pada wanita remaja muslim yang menggunakan jilbab.Benda asing tajam di bronkus harus segera dikeluarkan dalam kondisi dan peralatan optimal untuk mencegahkomplikasi yang timbul. Komplikasi akibat aspirasi benda asing tajam yang paling sering berupa perforasi jalan nafas,trakeitis, bronkitis, jaringan granulasi, efusi pleura dan atelektasis. Tindakan bronkoskopi merupakan pilihan untukekstraksi benda asing tajam yang teraspirasi. Dilaporkan dua kasus aspirasi benda asing tajam di bronkus yaitu padaseorang anak laki-laki, berusia 6 tahun dengan aspirasi paku dengan komplikasi atelektasis paru dan seorang anakperempuan, berusia 14 tahun dengan aspirasi jarum pentul tanpa komplikasi yang telah berhasil diekstraksimenggunakan bronkoskopi kaku.Kata kunci: benda asing tajam di bronkus, aspirasi paku, aspirasi jarum pentul, atelektasis, bronkoskopi kaku  Abstract Bronchial foreign body aspiration is a common problem in children and it is a serious problem that can befatal. Most of bronchial foreign body aspiration occur in children because of the tendency to put something into themouth, the molar growth is not yet complete, the lack of supervision from parents and others situation . Aspiration of apin in the bronchi usually occurs in adolescent Muslim women who wear headscarf. Sharp foreign bodies in thebronchi must be removed immediately and the optimal equipment to prevent complications. Complications due tosharp foreign bodies aspiration most often in the form of perforation, tracheitis, bronchitis, granulation tissue, pleuraleffusion and atelectasis. Bronchoscopy is the management  for aspirated sharp foreign body extraction   Reported two cases of a sharp foreign body aspiration is a boy, aged 6 year old with nail aspiration complication withlung atelectasis and a girl, aged 14 year old with aspirations of a pin without complications that have been successfully extract  using rigid bronchoscopy . Arial 9 italicKeywords:  sharp foreign bodies in the bronchi, nail aspiration, pin aspiration, atelectasis, rigid bronchoscopy


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.


Author(s):  
Kunzes Dolma ◽  
Anchal Gupta ◽  
Apurab Gupta ◽  
Padam Singh Jamwal

<p class="abstract"><strong>Background:</strong> The foreign body aspiration is one of the commonest ENT emergencies. Delay in diagnosis and treatment may lead to significant morbidity and mortality.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p><strong>Conclusions:</strong> 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. </p>


2021 ◽  
Vol 8 (26) ◽  
pp. 2306-2310
Author(s):  
Sreelatha Martha ◽  
Nirmala Cherukuri ◽  
Usharani Thota ◽  
Prasanna Kumar Korvani ◽  
Keerti Neelgiri ◽  
...  

BACKGROUND Foreign body aspiration (FBA) in children is one of the major causes of death in developing countries, the diagnosis of which can be missed due to varied presentation. It is one of the causes of choking among children which, if not recognized early may lead to fatal consequences. Early recognition and prompt intervention may reduce the mortality and morbidity. In this study, we wanted to assess the clinical profile of children with foreign body aspiration/ingestion, determine the nature and location of foreign body and also determine the outcome among children with foreign body aspiration at a tertiary care centre. METHODS This cross-sectional study was taken up to analyse the clinical profile, to study the types, location and the outcome of children with foreign body aspiration. All children in the age group of 2 months to 12 years admitted to Niloufer hospital, Hyderabad from January 2018 to December 2019 with either history of FBA or clinical features suggestive of FBA even in the absence of history were included in the study. Age, sex, clinical features (C/F), duration of illness were noted. A chest X-ray was done in all cases, whereas a computed tomography (CT) scan was done in children where clinical features & chest X-rays were inconclusive. All children fulfilling the inclusion criteria were subjected to bronchoscopy under general anaesthesia by ENT surgeons. The findings like type and location of the foreign bodies were noted. Statistical analysis was done by statistical package for social sciences (SPSS) software version 10.0. RESULTS Of 108 children studied, 60 % of cases were males and 40 % were females. 55 % of cases were below the age of 3 years. Common symptoms were rapid breathing (68 %) and cough (38.8 %). Nuts & seeds were the common foreign bodies seen in 47.30 %, out of which groundnuts were the most common. Organic foreign bodies accounted for 58.11 % while inorganic was 41.89 %. The common site of lodgement of foreign body was right main bronchus (35.59 %), followed by left main bronchus (27.11 %) and sub-glottis (8.47 %). CONCLUSIONS Foreign body aspiration is difficult to diagnose in children and a delay in diagnosis can lead to mortality and morbidity. Early intervention by bronchoscopy goes a long way in improving survival. Clinical suspicion is the key to the diagnosis. KEYWORDS Foreign Body, Bronchoscopy, Children


Author(s):  
Aishwarya Ullal ◽  
Arun P. Ajith

<p class="abstract">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.</p>


Author(s):  
Ihsan A. T. ◽  
Divya Ambooken

<p class="abstract"><strong>Background:</strong> 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.</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Walailak Tatsanakanjanakorn ◽  
Surapol Suetrong

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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