Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases (original) (raw)
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Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia, 2008
To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most common...
Tracheo-bronchial tree foreign body aspiration among children : A descriptive study
2015
Introduction: Our aim was to know the demographic and clinical profile of foreign body aspiration in tracheobronchial tree in pediatric age group and to understand the pre and post operative complications of foreign body aspiration in tracheobronchial tree in pediatric age group. Material & Methods: It was a descriptive study in ENT Department and Pediatrics Department, Krishna Hospital and Medical Research Centre. Karad with Sample size 59 Patients with confirmed diagnosis of Foreign body aspiration in Tracheobronchial Tree. Interview and clinical examination with the help of prestructured proforma. Results: 86.5 % children with tracheobronchial tree foreign body aspiration were below 3 years of age and 1.5 times more in males than females. 32.2% of cases were diagnosed within 24 hrs. Cough, Fever and Breathlessness were the commonest presenting symptoms with signs of Respiratory distress, tachypnoea, decreased air entry and rhonchi. In 28.8 % of cases, Radiographs were normal. In ...
Foreign body aspiration in children and role of flexible bronchoscopy: A 3year experience
The Gazette of the Egyptian Paediatric Association, 2016
Background: Flexible airway bronchoscopy is an accepted and frequently performed procedure in the evaluation of children with known or suspected airway and lung parenchymal disorders. Methods: Between 2012 and 2015, retrospective analysis of 134 flexible bronchoscopies was done in Children's Hospital, Cairo University, as regards demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on the basis of bronchoscopy inspection, conclusion and future recommendations. Results: Patients indicated for flexible bronchoscopy presented clinically with unilateral diminished breath sounds in 24.6%, unilateral bronchial breathing in 17.9%, recurrent lower respiratory tract infection in 11.2%, persistent cough in 4.5% and stridor in 9.7%, others showed radiological findings in the form of unilateral hyperinflation in 9%, bronchiectasis in 3.7% and unilateral wheezes in 1.5%. Out of 134 patients undergoing bronchoscopy, 38% had foreign body (FB) in the airways although only 7.5% of patients had recalled a previous history of FB aspiration (15.6% in the trachea, 52% in the right side and 31.3% in the left side, among those patients 60.8% were males while 39.2% were females), 14.1% had tracheal abnormality, 26.8% had post inflammatory changes, 56.7% had right bronchus abnormality, 55.2% had left bronchus abnormality, bronchoalveolar lavage (BAL) was done in 30.6% of patients, FB was successfully removed in 15.6% of patients and further cardiothoracic intervention was needed in 29.8% of patients. Conclusion: The combination of history, physical examination, and chest X-ray findings are crucial when investigating a child with suspected foreign body aspiration. Flexible bronchoscopy is effective for diagnostic and sometimes therapeutic purpose of problems in the upper and lower respiratory airways in children, with a high success rate as it significantly reduces the rate of negative rigid bronchoscopies and ultimately saves the child from undergoing an unnecessary procedure.
Foreign body aspiration in children: experience of 1160 cases
Annals of Tropical Paediatrics, 2003
Hospital records of 1160 children å 15 years old referred for suspected foreign body aspiration were reviewed. Bronchoscopy under general anaesthesia was performed on all patients. Foreign bodies were successfully removed in 1068 (92%) children. The majority, 885 (76.3%), presented with a de nite history of foreign body aspiration. Bronchoscopy was negative in 85 (7.3%) children. Watermelon seeds, found in 414 (38.7%) children, were the most commonly aspirated foreign bodies. Open surgical procedures were required for 21 (1.8%) children. Bronchial rupture related to bronchoscopy occurred in four children, two of whom died post-operatively. The overall mortality rate was 0.8%. Introduction of Thoracic and Cardiovascular Surgery in Dicle University School of Medicine for evaluation of tracheobronchial foreign body Foreign body aspiration is an important cause of morbidity and mortality in childhood aspiration. This centre is located in southeast Turkey and serves as a referral hospital and occurs most frequently in children aged between 6 months and 4 years. 1-4 In the for eight cities for treatment of foreign body aspiration. USA, 500 children die each year because of foreign body aspiration. 5 The diagnosis is The following information was recorded for each child: age, sex, presenting symptoms, challenging and can be overlooked because it usually occurs in infants and toddlers. 6 A time lapse between the onset of symptoms and admission to hospital, duration of hospital high index of suspicion is therefore necessary if accidental foreign body aspiration is to stay, type of foreign body removed and any complications. Bronchoscopy was performed be successfully diagnosed. 6 We present our clinical experience of 1160 children å 15 on all patients using a rigid bronchoscope under general anaesthesia in the operating years old from southeast Turkey with tracheobronchial foreign body aspiration. room. (A exible paediatric bronchoscope was not available.) An inhalation agent (Halotan 0.5-2.0%, Turk Hoecshst, Istanbul, Turkey) was administered by mask, and Materials and Methods succinylcholine (1.0-1.5 mg/kg) was injected for muscle relaxation. Airway control was Between January 1990 and March 2002, 1160 shifted to the bronchoscope when in place. children were admitted to the Department Maintenance anaesthesia was accomplished with 0.8-1.5% halotan and 100% oxygen inhalation. After removal of the broncho
Bronchoscopic techniques for removal of foreign bodies in children's airways
Pediatric Pulmonology, 2012
Introduction: The management of airway foreign bodies (AFB) can be a dramatic situation in the emergency treatment of children and different techniques have been used to improve the therapeutic success and minimize risks. Objective: to describe the bronchoscopic techniques used in the treatment of AFB in children referred to the Service of Respiratory Endoscopy of HC-FMUSP. Patients and methods: Retrospective analysis of 78 children who underwent bronchoscopy for foreign body removal, at our Service from February 2003 to April 2008. Results: 78 patients with an AFB, aged 08 months to 14 years, with 39 being organic and 39 inorganic foreign bodies. Nine foreign bodies were located in the central airway (four in the larynx and five in the trachea), 34 in the right bronchial tree and 33 in the left bronchial tree. There was bilateral aspiration in two cases. All patients were initially submitted to diagnostic flexible bronchoscopy. A rigid bronchoscope was used in 39 cases; a flexible bronchoscope in 23 and an association of techniques in 15 cases (rigid bronchoscopy, flexible bronchoscopy, suspension laryngoscopy, and fluoroscopy). Discussion: Although the rigid bronchoscopy is considered the main tool for the removal of foreign bodies from airways, other useful techniques deserve attention as part of the medical training. Conclusion: The knowledge and association of different methods in pediatric bronchoscopy add the benefits of one method to another, minimizing the chances of therapeutic failure.
Bangladesh journal of endosurgery, 2013
Background: Foreign body aspiration is a common cause of pulmonary complications and accidental death in children. A high index of suspicion and an early bronchoscopy are essential for the removal of an aspirated foreign body to prevent morbidity and mortality. Methods: This is a retrospective audit of the cases of aspirated foreign bodies in children up to 15 years of age managed in our unit over a 16-year period from 1st February 1995 to 31st January 2011. Results: There were 37 children with the diagnosis of foreign body aspiration during this period. Twenty-seven of these children resided between 50 and 200 km from our hospital. The age ranged from 14 months to 14 years. Twenty-one of these patients presented with an acute onset of respiratory distress without a history of choking. A radioopaque foreign body was visible only in 13 children. In 14 patients, the chest radiograph was normal. The foreign bodies were removed by rigid bronchoscopy. In 29 out of the 37 children the foreign body was non-food product. One patient had a tension pneumothorax and surgical emphysema which settled with a chest drain. Conclusion: An early bronchoscopy, done by a competent surgeon with a rigid bronchoscope deals effectively with the problem of aspirated foreign body, with minimum morbidity. The ability to safely remove an aspirated foreign body is an essential skill to be acquired as part of the training of paediatric surgeons in the developing world.
[Foreign body aspiration in children]
PubMed, 2004
Objectives: The aim of this study was to present the demographic data of our patients who underwent bronchoscopy for suspected aspiration of a foreign body. We also assessed the sensitivity and specificity of history, symptoms, physical examination, and radiological findings in these patients. Patients and methods: One-hundred and two patients underwent bronchoscopy for suspected foreign body aspiration during a 23-month period. Bronchoscopy was performed under general anesthesia with a rigid bronchoscope. Results: A foreign body was detected in 78 patients. The male-to-female ratio was 1.7:1, the mean age was 30.4 months, and the median age was 18 months. Nut and sunflower seeds were the most common types of foreign bodies. There were three minor complications and no death in our series. No tracheotomy or thoracotomy were required. The sensitivity and specificity of history, symptoms, physical examination, and radiological findings for suspected foreign body aspiration were 100% and 4.2%, 97.4% and 8.4%, 89.7% and 37.5%, 76.8% and 50%, respectively. Conclusion: A chocking crisis is an absolute indication for bronchoscopy. Our low complication rate allowed us to perform bronchoscopy more liberally in patients with suspected foreign body aspiration. The sensitivity of history, symptoms, and physical findings were very high, whereas the specificity of history and symptoms were very low.
Revista do Hospital das Clínicas, 2002
Foreign body aspiration (FBA) is one of leading causes of death in children, especially among those younger than 3 years of age. The inhalation of a foreign body may cause a wide variety of symptoms, and early diagnosis is highly associated with the successful removal of the inhaled foreign material. Despite the great advances in endoscopic procedures and anesthesia, a large number of difficulties and complications still result from foreign body aspiration. We describe 5 cases of serious acute complications following aspiration of foreign bodies that became lodged in the tracheobronchial tree, including pneumomediastinum, pneumothorax, total atelectasis, foreign body dislodgment, and need for thoracotomy in children admitted into our intensive care unit in 1999 and 2000; these were all situations that could have been prevented with early recognition and prompt therapeutic intervention.
Is Early Diagnosis of Foreign Body Aspiration Effective in Reducing Re-bronchoscopy in Children?
2021
Background:Flexible Fiber-optic Bronchoscopy (FFB) is a diagnostic and therapeutic tool for respiratory diseases and evaluation. One of its major advantages is in the diagnosis and treatment of foreign body aspiration.Objectives:This study reports the indications, outcomes, and possible complications of FFB in patients suspected of foreign body aspiration diagnosis in the Iranian population.Methods:The data for this study was gathered from medical records of the patients in Children’s Medical Centre, which is a tertiary pediatric hospital affiliated with Tehran University of Medical Sciences (TUMS), from August 2015 to February 2021.Results:Of the 358 FFBs that were performed for patients suspected of foreign body aspiration diagnosis, major indications included choking (158, 44.13%), coughing (157, 43.58%), wheezing (34, 9.49%), and stridor (6, 1.67%). Nuts were the most common foreign body that was removed among airways in these patients (116, 65.16%). In 15 (4.18%) cases the fore...