Tracheo-Bronchial Foreign Bodies: Our Experiences (original) (raw)

Tracheo-Bronchial Foreign Bodies: A Retrospective Study and Review of Literature

Indian Journal of Otolaryngology and Head & …, 2011

Tracheobronchial foreign body aspiration is a common emergency in childhood constituting major cause of mortality. Although ample studies regarding airway foreign bodies are present in western literature, studies in Indian context are however lacking. The aim of the study is to present an epidemiological data regarding airway foreign bodies in Indian context thereby helping to analyze the situation with regard to our socioeconomic condition. Retrospective file review of all case (n = 82) that underwent rigid bronchoscopy for suspected tracheo-bronchial foreign body over a period of 7 years (2001-2008) in the department of otolaryngology of a tertiary care centre of eastern India. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted in an attempt to define the epidemiology, clinical presentation, management and associated morbidity. Most common age of presentation was between 1 and 3 years (56.4%). Most common symptom in our study was Cough, wheezing and respiratory distress (63.4%). Most common clinical signs at presentation were diminished breath sound in unilateral lung field seen in 36.6% cases. Most common radiological finding on chest radiograph was collapse seen in 41.65% cases. Most common type of foreign body below 3 years of age was food material (seeds, beans) removed in 48.78%. Complications were encountered in 14.6% cases of which most common complication was bronchospasm and acute respiratory distress seen in 41.6% cases.

Tracheo-bronchial foreign bodies presentation, diagnosis management at tertiary care center

IP innovative publication pvt. ltd, 2019

Introduction: The aim of this work was to study the clinical presentation of tracheo-bronchial foreign body aspiration in children for early diagnosis and prompt treatment. This article attempts to address the potential hazards of foreign body aspiration in children and its subsequent management. Materials and Methods: This is a prospective study of 63 cases in age group of 1 to 8 years that underwent Rigid Bronchoscopy for suspected tracheo-bronchial FB over a period of three years in the ENT Dept. of Venkateshwara Institute of Medical sciences. Cases presented in ENT OPD or referred from emergency/department of paediatrics, with history/ suspicion of foreign body aspiration, with sudden breathlessness, sudden onset of cough with or without cyanosis/ pyrexia were included in the study. Results: In our study, mean age of patients presenting with foreign body aspiration is 2.4 years. Males (57.1%) presented with foreign body aspiration more frequently as compared to females (42.9%). In 62% cases, there was definite history of foreign body ingestion observed by parents or relatives. Maximum no. of patients presented with sudden onset of cough 38%, followed by sudden onset difficulty in (17.4%), noisy breathing (14.2%), hoarseness of voice(11.2%), vomiting and retching (11.2%), 7.9% patients presented with drooling of saliva(7.9%). In our study majority of FB in air passage were in left main bronchus 54% followed by right main bronchus 36.5% and 6.3% in carina. Conclusion: Tracheo-bronchial foreign body aspiration is common in children. Foreign body aspiration may present as un-witnessed episode and a high index of suspicion, even in absence of a positive history, it is necessary to prevent morbidity and mortality due to delayed or misdiagnosis. Foreign body aspiration is an emergency and should be removed by rigid bronchoscopy at the earliest to prevent fatal complications.

Tracheobronchial Foreign Bodies: The Importance of Timely Intervention and Appropriate Collaboration

Indian Journal of Otolaryngology and Head & Neck Surgery, 2019

The aim of study is to determine epidemiological profile of the cases suspected to have laryngotracheobronchial foreign body, average interval between onsets of symptoms and presentation to our tertiary centre, average interval between admission and active surgical intervention, incidence of various clinical, radiological and intraoperative findings. All patients presenting to our institution with suspicion of foreign body inhalation who underwent rigid bronchoscopy from October 2012 to April 2018 were considered for this study. Data compilation of these patients was done which included age, sex, chief complain, time of onset, time of presentation to hospital, time till intervention was undertaken, clinical and radiological findings, nature of foreign body, history of ingestion, intraoperative findings and post-operative recovery. All these aspects were then evaluated. Our study included 89 cases who underwent rigid bronchoscopy under General Anaesthesia. 67.4% were male and 71% were children less than 2 years of age. 36% presented within the first 48 h and 64% of these were managed within 24 h of presentation. Of these 50.6% gave history of foreign body inhalation and cough was the most common presentation in 92.1%. Collapse was the most common radiological finding in 42.7% cases. Lodgement of foreign body was slightly more on right side (45.5%). Most of the foreign bodies were of vegetative nature-84.7%. There was no mortality out of all 89 cases. Although the mortality and complication rate has decreased significantly after the advent of endoscopically assisted bronchoscopy, still attention needs to be given to earlier diagnosis of foreign body aspiration and earlier referral to an ENT surgeon for bronchoscopy if required. Also the time duration between intervention to be undertaken from the time of symptom onset can be decreased with a better collaboration between the Radiologist, the Paediatrician and the Otorhinolaryngologist.

Airway foreign bodies: our six years' experience with 301 cases

International Journal of Contemporary Pediatrics, 2016

Foreign body aspiration (FBA) is a common problem in children and accounts for an important cause of morbidity and mortality. It is potentially life threatening event and may also cause chronic lung injury if not properly managed in time. 1-4 The diagnosis and the treatment of the tracheobronchial FBs require awareness about the problem and highest degree of suspicion of signs and symptoms. 5-7 The most important concern is the timely diagnosis and safe and speedy removal of the foreign bodies from the airway. 3,7 The accurate diagnosis may be missed by treating physician because often the initial choking episode is not witnessed and the delayed residual symptoms may mimic other common conditions such as asthma, recurrent pneumonia or upper respiratory infection. 3,8,9 The symptoms and signs produced depend upon the nature, size, location and time since lodgment of the foreign body in the tracheo bronchial tree. A large foreign body occluding the upper airway may lead to ABSTRACT Background: Foreign body aspiration (FBA) is a common problem in children and accounts for an important cause of morbidity and mortality. The main objective of this study was to evaluate the clinico-demographic profile and management of foreign body (FB) aspiration in hospitalized patients. Methods: This was a retrospective study conducted at Indira Gandhi institute of child health, Bangalore during the period from January to December 2015. All patients who gave a history of FBA or suspected of FB aspiration, those who had recurrent chest infection and who had undergone bronchoscopy were included in the study. Medical records were used for data collection of cases recurrent chest infections. The diagnosis of FBA was made from the documented clinical presentations, physical findings and investigations like chest X ray, CT scan whenever done. The management included rigid bronchoscopy and surgical interventions like tracheotomy, thoracotomy with bronchotomy and thoracoscopic retrieval. Results: Most of the patients were in the age group between 1 to 3 years 206 (68%). Males were more affected 217 (72%) than females 84 (27.9%). 290 patients (96.3%) presented early (within 7 days of aspiration) with cough and respiratory distress. FBs were found impacted in the right bronchial tree more commonly, 195 (82.2%), followed by left bronchial tree in 30 (12.6%) and in the trachea 8 (3.3%) cases. In failed bronchoscopy cases, other surgical modalities like tracheotomy, laryngotomy, bronchotomy, thoracoscopic retrieval were attempted. Conclusions: Children of the age group 1-3 years were found most vulnerable for FB aspiration. FBs were mostly vegetative and were found mostly in the right bronchial tree. Removal of FB by rigid bronchoscopy was safe and effective when patients presented early. Surgical modalities of management like tracheotomy, laryngotomy, bronchotomy were needed in cases of late presentation.

Different Modalities Used in the Art of Managing Tracheobronchial Foreign Bodies

The Open Respiratory Medicine Journal

Introduction: Foreign body aspiration is a commonly encountered and challenging emergency. Foreign body aspiration causes significant morbidity and mortality in the paediatric population. In adults, it is usually encountered in patients with impaired consciousness and in young females using pins to secure their veils. We aimed to analyse the incidence, type and site of foreign body, radiological presentation, complications and different modalities used in managing tracheobronchial foreign bodies (FBs). Methods: A prospective single centre cross-sectional study between December 2010 and December 2011 in the Department of Cardiothoracic Surgery at the University of Alexandria, Egypt. Results: Seventy-eight patients were included. The age of the patients ranged between 1.3 and 32 years, with a mean of 13.37± 7.67 years. Inorganic FBs were the most common aspirated FBs (66 patients, 84.62%). FBs were more frequently located in the left versus the right bronchial tree (44.9% vs. 43.6%). ...

Extraction of airway foreign bodies in adults: experience from 1987-2008

Interactive cardiovascular and thoracic surgery, 2009

To determine the incidence and the clinical, radiographic, and endoscopic characteristics of adult patients in our area diagnosed with tracheobronchial foreign bodies (FBs), we have performed a descriptive retrospective study analysing rigid and flexible bronchoscopies practised at our department between 1987 and 2008 in patients older than 14 years. Of the 9781 bronchoscopies performed, 32 involved cases of bronchoaspiration of FBs. The mean age of the patients was 43.81 years (S.D. 21.43); 65.6% were male and 34.4% were female. Acute or recurrent infection was the most frequent clinical presentation. Chest radiographs provided data for diagnosis in 68% of the cases. The most common FB aspirated were inorganic (pins and plastic devices 21.4%, respectively). In conclusion, we can state that in our area tracheobronchial aspiration of FBs by adults is not common. The clinical symptoms are highly variable and the FBs are usually lodged in the right bronchial tree.

Removal of Foreign Bodies In Pediatric Airway- our experience

2015

A retrospective study of 108 cases of tracheobronchial foreign bodies was analyzed. History, clinical findings, radiological features, type of material & location of foreign bodies were studied. In our study of the 108 children who underwent rigid bronchoscopy, 102 had tracheobronchial foreign bodies (94.4%). Foreign body aspiration happened mostly in children below 3yrs of age (84.3%), choking preceded the symptoms in 82 cases (80.3%). Very few, 9 patients reported within 24hrs of the event (8.8%). There was a delay of more than 2 weeks in 13 (12.7%) cases. In many cases referral was delayed as the diagnosis was missed initially. Vegetative foreign body, Groundnuts were present in majority of the cases (65.6%). Use of proper instrumentation, through training and teamwork is the key to achieve goal of zero mortality and no major complications. A total of one hundred and eight children were admitted with suspected foreign body aspiration during this period. No foreign body was found ...

When tracheotomy was the only resort in paediatric tracheo-bronchial foreign body: case report

International Journal of Otorhinolaryngology and Head and Neck Surgery

The pediatric individual is likely to present with an aspirated foreign body that maybe oriented as such that it may necessitate often an alternate route for removal. Rigid bronchoscopy with jet ventilation is the intervention undertaken at the earliest. In wide caliber foreign bodies a different approach has to be adopted. Tracheotomy, thoracotomy, bronchotomy and pneumonectomy are the next level procedures. A cervical tracheostomy had to be undertaken in a child with a week old impacted conical tail cap of a ball point pen.