BACKGROUNDTracheobronchial foreign body aspirations, which threaten lives in childhood, also carry potential risks during and after bronchoscopy. The aim of this study is to review complications and precautions that need to be taken against possible risks.METHODSFrom 1987 to 2005, bronchoscopy was done in 1035 children in our department on suspicion of foreign body aspiration. The average age of these patients, mostly male (55%), was 4.1 years. Medical history, physical examination, radiological methods and bronchoscopy were used in the diagnosis. Bronchoscopy was applied under general anaesthesia, and the respiratory and cardiac systems were closely observed for 4 hours after the process.RESULTSNine hundred eleven of 1035 patients (88%) had a foreign body in the tracheobronchial system. In 42 of the patients, infection required aggressive medication; in 30, hypoxia and bradycardia occurred as a result of obstruction during bronchoscopy; in 37, laryngeal edema, laryngeal spasm and/or bronchospasm required ventilation support; in 6 patients, tracheobronchial system bleeding occurred; in 2 patients pneumothorax occurred, in 1 patient pneumomediastinum was observed and 6 patients needed thoracotomies because of foreign body aspiration. In this series there were 8 deaths.CONCLUSIONBronchoscopy, performed for tracheobronchial foreign body aspiration, carries a potential life-threatening risk during and after the process. The clinician needs to be aware of these risks, take proper precautions, and perform bronchoscopy by taking the medical condition of the patient and characteristics of the inspired foreign body into consideration.

Turban pin aspiration is common in Islamic populations and treatment usually requires bronchoscopic procedures. In order to minimize turban pin aspiration frequency, we recommend that turbans should be secured by traditional fastening methods or with an apparatus which cannot be aspirated.

The effective treatment of hydatid cysts in the lung is the complete excision of the cyst with maximum preservation of lung parenchyma. We believe that the decision of lobectomy must be taken very carefully, even in the case of infected hydatid cysts, atelectasis, giant cysts and multiple cysts in the same lobe.

BackgroundHydatid cyst disease is still a problem in many countries. Surgical removal is currently the generally accepted choice of treatment for lung hydatidosis. However, operating on bilateral widespread lung hydatidosis is still controversial. The aim of this retrospective study was to evaluate the results of surgical treatment in bilateral multiple hydatid disease of the lung.MethodsIn this study, we reviewed our experience in the surgical treatment of 17 (3.7%) patients with bilateral, and at least three, lung hydatid cysts. These 17 patients (8 male, 9 female), with an average age of 34.6 years (range 12–58 years), underwent bilateral staged thoracotomy.ResultsIn total 105 lung cysts were removed from 17 patients who underwent staged thoracotomies. The mean count of cysts was 6.7 (range 3–20 cysts). Most of the cysts (38.2%) were located in the right lower lobe. The mean interval between thoracotomies was 4.2 (range 3–5) days. Two patients (11.7%) had cysts associated with hepatic hydatidosis and one (5.8%) had cysts associated with the spleen; they were treated via phrenotomy during thoracotomies. All cysts were removed without lung resection. We observed some complications such as prolonged air leaks (n = 2), atelectasis (n = 3) and empyema (n = 2). No further surgery was required for management of complications. The mean hospital stay was 9.3 days. (range 7–23 days). Oral albendazole was started on the 2nd post operative day after the first thoracotomy in the dose of 10–20 mg/kg and was continued for 3 months with a gap of 1 week after each 21 days. No recurrences or deaths occured during the follow-up period.ConclusionsAlthough staged thoracotomy applied in 3–5 days after the initial thoracotomy increases the total hospital stay, it decreases the chance of possible complications can occur in cysts in the other lung when long intervals are preferred between the first and the second thoracotomy. In our experience, bilateral staged thoracotomy is an appropriate surgical option because morbidity rates are minimal and the hospital stay is acceptable for the treatment of bilateral widespread lung hydatidosis, even in patients who had a total of 20 hydatid cysts.

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