ENDOSCOPIC MANAGEMENT OF PIN STUCK INTO THE SEGMENTAL BRONCHUS

This case is a challenging case review of a successful removal of sharp and deep located airway foreign body using ventilating bronchoscopy.

Fractured intubating stylet: A case of airway foreign body in Intensive care Unit

not available Bangladesh Crit Care J March 2021; 9(1): 41-42

Removal of Airway Foreign Body in a Premature Neonate

Objective: Airway foreign bodies are the leading cause of infantile deaths and fourth among preschool children. Airway foreign bodies in extremely premature neonates represent a rare but potentially lethal entity. There are very few reports in the literature describing the treatment of such a condition in premature neonates. The objectives of this report are to describe the safe removal of an airway foreign body in an extremely premature infant using urologic instruments in a trans-endotracheal tube fashion and to review the literature for other techniques that have proven safe and effective, thereby adding technical options for future cases. Methods: We reviewed the case reported and reviewed pertinent literature. Results: A 2-week old, ex-24 3/7-week, 820-g pre-mature infant was intubated with a 2.5 endotracheal tube. After intubation, a 2-cm foreign body was discovered in the distal trachea by chest x-ray. The child’s respiratory status continuously deteriorated with increasing oxygen and positive pressure requirements. While remaining intubated, the child underwent direct suspension laryngoscopy, the ventilator circuitry was disconnected, and the object was successfully removed using a 1.2 mm rigid ureteroscope and 1.1 mm grasping forceps through the 2.5 endotracheal tube. Conclusion: This case report demonstrates the effectiveness of using a 1.2 mm ureteroscope and 1.2 mm urologic graspers to extract an airway foreign body from an extremely premature neonate through an endotracheal tube without paralyzing the patient. This method provides a safe and effective means of visualizing and, if necessary, manipulating the airway in a population prone to respiratory complications.

First-aid Fast Track Channel in Rescuing Critically Ill Children With Airway Foreign Body: Our Clinical Experience

Objective To explore the role of First-aid Fast Track channel in rescuing children with airway foreign body, and to analyze and summarize the experience and lessons of First-aid Fast Track channel in rescuing airway foreign body in critical condition. Methods Clinical data of 21 cases of First-aid Fast Track channel rescue admitted to our hospital from January 2017 to December 2020were retrospectively collected, including 12 males and 9 females, aged 9-18 months, with an average age of 15 months and a history of 1-72 hours. Follow-up medical history showed that all 21 children had a history of significant foreign body cough. Results 21 cases of airway foreign body were successfully removed without second operation. Twenty-one critically ill children were intubated into PICU after surgery. Two of the children had a history of asphyxia rescue in a foreign hospital. After endotracheal intubation and cardiopulmonary resuscitation, the ambulance was sent to our hospital. Although the foreign body was removed, the patient's family gave up the treatment because the brain hypoxia lasted too long and the deep coma could not be recovered. Conclusion First-aid Fast Track channel of airway foreign body is the cooperation of otolaryngology, anesthesiology, ICU, emergency room and other departments, which has won valuable time for rescue, highlighted the purpose of rescue, improved the success rate of rescue and the quality of life of children, and is of great value for the treatment of critical tracheal foreign body.

Airway Foreign Body Mimicking an Endobronchial Tumor Presenting with Pneumothorax in an Adult: A Case Report

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.