scholarly journals Diagnostic challenges in paediatric foreign body aspiration: a case report

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.

scholarly journals Light Emitting Diode (LED) Bulb Aspiration in Northern Ghana: A Case Report and Literature Review

2020 ◽  
pp. 26-29
Author(s):  
Theophilus Adjeso ◽  
Adamu Issaka
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Foreign Body ◽  
Literature Review ◽  
Light Emitting Diode ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Northern Ghana ◽  
Light Emitting ◽  
History Of

Light emitting diode (LED) bulb is an unusual cause of foreign body aspiration. We present a case of a 6-year-old boy who reported with a four-day history of difficulty in breathing and cough following a LED bulb aspiration retrieved via rigid bronchoscopy. This present case suggests that LED bulb should be considered in the differential diagnosis of foreign body aspirations in our environment.

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

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.

scholarly journals A gyermekkori alsó légúti idegentest-aspiráció diagnosztikája a klinikai gyakorlatban

2018 ◽  
Vol 159 (51) ◽  
pp. 2162-2166
Author(s):  
Dániel Hajnal ◽  
Tamás Kovács
Keyword(s):  
Foreign Body ◽  
Standard Procedure ◽  
False Negative ◽  
Radiological Finding ◽  
Paediatric Population ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
X Ray ◽  
Co Morbidity ◽  
Chest X Ray

Abstract: Introduction and aim: Rigid bronchoscopic foreign body removal is the gold standard procedure for foreign body aspiration. We have analysed our results of bronchoscopies and the accuracy of diagnosis among the paediatric population in Southeast Hungary. Method: A retrospective study of children admitted because of suspected solid foreign body aspiration between 2006 and 2017 was performed. Results: From among 220 admitted patients, 86 were suspected of solid particle aspiration. Presenting history was certain in 68.6% (n = 59/86). Sudden choking-like symptoms were present in 61/86 patients (70.9%), coughing in 81/86 patients (94.2%). Thoracic auscultation was positive in 67/86 cases (77.9%), chest X-ray in 75/86 patients (87.2%), while fluoroscopy only in 12/75 cases (16%). 92 bronchoscopies in 86 patients were performed. In 57 bronchoscopies, solid foreign body was found (66.2%) and the removal was successful in 56 cases. Thoracic auscultation was negative in patients with foreign body only in 6/57 cases (10.5%). In the same group, chest X-ray was negative in 33/57 cases (57.9%) and fluoroscopy was positive only in 12/57 patients (21.1%). Pneumonia or prolonged bronchitis was present in 4/86 patients (4.6%). Severe bronchial bleeding occurred in 2/86 cases (2.3%). Mortality was 1.2%, a child with severe co-morbidity and chronic aspiration passed away. Bronchoscopy was negative in 29/86 patients (33.7%). Complications were significantly higher in chronic cases than in the acute ones. Conclusion: Rigid bronchoscopy is indicated if solid foreign body aspiration is suspected and positive anamnesis, typical symptoms (coughing, choking) or positive chest auscultations are present. Diagnosis predominantly based on radiological finding is controversial due to the high possibility of false negative results. Early intervention within the first 24 hours is recommended to avoid complications. Orv Hetil. 2018; 159(51): 2162–2166.

scholarly journals A Case of Whistle as Foreign Body in Trachea

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.

scholarly journals Scarf pin-related hijab syndrome: A new name for an unusual type of foreign body aspiration

2017 ◽  
Vol 45 (6) ◽  
pp. 2078-2084 ◽  
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.

scholarly journals ROLE OF RIGID BRONCHOSCOPY IN MANAGEMENT OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION

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.

scholarly journals A vaginal fornix foreign body in a bitch: a case report

2014 ◽  
Vol 59 (No. 9) ◽  
pp. 457-460 ◽  
Author(s):  
M. Fabbi ◽  
S. Manfredi ◽  
F. Di Ianni ◽  
C. Bresciani ◽  
AM Cantoni ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Foreign Body ◽  
Staphylococcus Epidermidis ◽  
Foreign Bodies ◽  
Clinical Signs ◽  
Abdominal Ultrasound ◽  
Intact Female ◽  
History Of ◽  
Grass Awn

A six-year-old intact female Lagotto Romagnolo was referred with a two-day history of purulent vulvar discharge associated with fever, lethargy, polyuria, polydipsia and signs of abdominal pain. Abdominal ultrasound revealed a grass awn foreign body in the vaginal fornix. Culture swabs obtained from the vagina revealed the presence of Staphylococcus epidermidis as the preponderant organism. Ovariohysterectomy was performed, and the presence of the grass awn was confirmed. A chronic-active vaginitis was found at histological examination. The dog recovered with resolution of all clinical signs.  Differential diagnoses for acute vulvar discharge in bitches should include retention of vaginal foreign bodies. To the authors’ knowledge, this is the first reported case of a grass awn foreign body in the vaginal fornix of a dog.  

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

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.

scholarly journals SEX AND AGE WISE DISTRIBUTION, PRESENTATION AND SUCCESSFUL REMOVAL AND MORTALITY OF FOREIGN BODY ASPIRATION USING RIGID BRONCHOSCOPE IN CHILDREN OF DISTRICT D.I.KHAN, PAKISTAN

2020 ◽  
Vol 18 (01) ◽  
pp. 3-11
Author(s):  
Ali Khan ◽  
Mohammad Ismail Khan ◽  
Muhammad Afaq Ali ◽  
Altaf Hussain ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Foreign Body ◽  
Age Groups ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Age Group ◽  
Mortality And Morbidity ◽  
X Ray ◽  
Medical College ◽  
History Of ◽  
Successful Removal

Background: Foreign body aspiration commonly occurs in young children and is associated with high degree of mortality and morbidity. The objectives of this study were to determine epidemiologic, clinical and endoscopic perspectives of foreign body aspiration in children of District D.I.Khan, Pakistan. Materials & Methods: This descriptive study was conducted in Department of ENT, Gomal Medical College/ DHQ Teaching Hospital, D.I.Khan, Pakistan from November 2017-April 2019. 105 children with suspected foreign body (FB) aspiration were included. All patients underwent rigid bronchoscopy under GA. After check X-ray and one day observation, they were discharged. Variables were sex, age in years and age groups, successful removal, mortality, history of FB aspiration, cough, wheezing, choking, stridor, reduced air entry and location of FB. Age in years was numeric, age groups ordinal and all other variables were on nominal scale. Age in years was described by mean & SD and others by count and percentage. Results: The sample with suspected foreign body aspiration (n=105) included 61 (58.1%) boys and 44 (41.9%) girls, with 20 (19.05%) in age group 0-2.0 years, 58 (55.24%) 2.0-5.0 years and 27 (25.71%) 5.0-14 years. Chest X-Ray was done in 98/105 (93.33%) cases. Frequency of successful FB removal by rigid bronchoscopy was 86/105 (81.90%). Mortality was none. Out of 86 confirmed cases, 51 (59.30%) were boys and 35 (40.70%) girls, with 19 (22.10%) in age group 0-2.0 years, 55 (63.95%) 2.0-5.0 years and 12 (13.95%) 5.0-14 years. Mean age was 3.57±1.78. History of FB aspiration was in 75/86 (87.21%), cough 65 (75.58%), stridor 14 (16.28%), wheezing 54 (62.79%) and choking 28 (32.56%) cases. Reduced air entry was 44 (51.16%) on right side, 17 (19.77%) on left side and 25 (29.05%) bilateral. Location of FB was larynx 6 (9.98%), trachea 20 (23.26%), right bronchus 44 (51.16%) and left bronchus 16 (18.60%). Conclusions: Foreign body aspiration in children in not an uncommon event. The parents should try to prevent such event, and if there, should present the child to emergency department of a hospital. ENT surgeons are supposed to evaluate and plan an earlier intervention as rigid bronchoscopy for these children.

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