CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration

Haliloğlu, Mithat; Çiftçi, Arbay Ö.; Oto, Aytekin; Gümüş, Burçak; Tanyel, Feridun Cahit; Şenocak, Mehmet Emìn; Büyükpamukçu, Nebìl; Besim, Aytekin

doi:10.1016/s0720-048x(02)00295-4

Cited by 127 publications

(107 citation statements)

References 19 publications

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“…Virtual bronchoscopy with multislice CT is a new diagnostic modality which can show whole tracheobronchial tree and give foreign bodies' 3D location and has a sensitivity and specificity of nearly 100% [11,20]. In our case, CT was not perfomed under virtual bronchoscopy mode so no foreign body was observed but some secondary signs such as increased aeration and stenosis in bronchial lumen was evident.…”

Section: Discussionmentioning

confidence: 67%

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An Interesting Case of Aspiration In a Patient With Asthma

Candemir¹,

Ergün²,

Kaymaz³

et al. 2015

JCR

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Abstract:Aspiration of a foreign body is a life-threatening emergency which is seen exclusively in childhood. Some cases are detected in adulthood with very variable symptoms according to localization of the material. The history is very important in diagnosis as the foreign bodies in the tracheobronchial tree may mimick many pathologic conditions. Wrong diagnosis may lead to inappropriate interventions or irrational treatment. This report presents a patient with aspirated foreign body in main bronchus who had been followed and treated for difficult asthma.

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Section: Discussionmentioning

confidence: 67%

“…The first test to be done in case of a suspicion of a foreign body aspiration is chest X-ray which has a sensitivity of 60%-85% and specificity of 52%-68% [11,12]. Posteroanterior chest X-ray has a sensitivity of 75%-97% [13][14].…”

Section: Discussionmentioning

confidence: 99%

An Interesting Case of Aspiration In a Patient With Asthma

Candemir¹,

Ergün²,

Kaymaz³

et al. 2015

JCR

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“…(3) In a study with similar characteristics, an 85% sensitivity and a 68% specificity were demonstrated. (2) In other studies, the conclusion reached was that the absence of radiological alterations does not exclude a diagnosis of FBA. (9,10) In order to increase radiological accuracy, fluoroscopy imaging can be conducted in inhalation and exhalation, in lateral decubitus.…”

Section: Discussionmentioning

confidence: 94%

“…In another study, when images obtained by means of VB and conventional bronchoscopy in patients with suspected FBA were compared, similar results were found. (2) In a recent study comparing VB and conventional bronchoscopy, the estimated sensitivity and specificity of VB were 96% and 58%, respectively. (12) Another group of authors recently published a study comparing VB and rigid bronchoscopy in patients with suspected FBA, (15) suggesting that the use of this new technique can shorten the time to the performance of bronchoscopy and accurately locate the FB.…”

Section: Casementioning

confidence: 99%

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Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho

et al. 2009

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Foreign body aspiration (FBA) into the tracheobronchial tree is a common problem in children, especially in those under three years of age. Preliminary radiological evaluation reveals normal chest X-rays in nearly 30% of such patients. Tomography-generated virtual bronchoscopy (VB) can facilitate the early diagnosis and rapid management of these cases. The definitive treatment is the removal of the foreign body by means of rigid bronchoscopy under general anesthesia. The objective of this study was to describe the use of VB in two patients with suspicion of FBA, as well as to review the literature regarding this topic. The two patients presented with sudden onset of respiratory symptoms and history of cough or choking with foods before these symptoms. Both patients were submitted to VB. In both cases, we detected an endobronchial foreign body, which was then removed by conventional rigid bronchoscopy in one of the cases. Only recently developed, VB is a noninvasive imaging method that has potential for use in detecting foreign bodies in the airways of children. In select cases, VB can indicate the exact location of the foreign body and even preclude the need to submit patients to rigid bronchoscopy in the absence of a foreign body.Keywords: Bronchoscopy; Pediatrics; Respiratory aspiration. ResumoA aspiração de corpo estranho (ACE) para o trato respiratório é um problema comum em pacientes pediátricos, em especial abaixo dos três anos de idade. Na avaliação radiológica inicial, cerca de 30% dos pacientes apresentam radiograma de tórax normal. A tomografia com broncoscopia virtual (BV) pode auxiliar no diagnóstico precoce desse quadro e seu pronto manejo. O tratamento definitivo se dá com a retirada do corpo estranho através de broncoscopia rígida e mediante anestesia geral. O objetivo deste trabalho foi descrever o uso da BV na abordagem de dois pacientes com suspeita de ACE e realizar uma revisão da literatura sobre este tópico. Os dois pacientes tiveram início súbito de sintomas respiratórios e relato de tosse ou engasgo com alimentos antecedendo o quadro. Os pacientes foram submetidos à BV, e foi detectada a presença de corpo estranho endobrônquico em ambos os casos, com remoção posterior por broncoscopia rígida convencional em um caso. A BV é um método não-invasivo recente e com potencial para detectar a presença de corpo estranho na via respiratória em crianças. Em casos selecionados, BV pode auxiliar na localização correta do corpo estranho e até mesmo evitar o procedimento de broncoscopia rígida na ausência de corpo estranho.

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Camplyobacter empyema due to food aspiration

Behl

Manchanda

Thomas

2008

Journal of Hospital Medicine

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A 72-year-old man had been suffering from low-grade fever, minimally productive cough, and shortness of breath for 1 week when he experienced sudden, moderately severe right-sided chest pain. His local primary care physician found no abnormalities on physical exam and laboratory testing. A chest x-ray, however, did reveal a small right-sided pleural effusion. The patient was empirically started on levofloxacin but noticed no improvement. Two weeks into his illness, he was referred to our institution for further management. By this time, he reported a rapid 10-pound weight loss and a daily low-grade fever. Chest examination revealed dullness to percussion along with decreased breath sounds in the right posterior lung fields. A complete blood count showed an elevated white count of 17,000/mL with 14,000 neutrophils. Hemoglobin was 13.5 g/dL. A repeat chest x-ray and then a CT scan showed a multiloculated pleural effusion in the right lower hemithorax. Ultrasound-guided tap of this effusion showed cloudy fluid consistent with pus, with a protein of 4.8 g/dL and total nucleated cells of 6000/mL. A gram stain on this fluid was negative.The patient had a history remarkable for severe underlying chronic obstructive pulmonary disease (COPD). His forced expiratory volume in 1 second (FEV1) was 21%, and his diffusing capacity of carbon monoxide (DLCO) was 27%. Therefore, decortication under general anesthesia was not an option. So the largest pus pocket was drained under CT guidance, and the patient was dismissed home on levofloxacin.He returned for follow-up after 3 weeks and reported daily low-grade fever, night sweats, and an additional weight loss of 14 pounds. His white count had risen to 18,300/mL with a neutrophil count of 16,600. Hemoglobin had fallen to 11.9 g/dL. A repeat CT scan showed that although the previously drained fluid pocket had resolved, a moderate amount of fluid had reaccumulated in other pockets. Delayed anaerobic culture results from the hospitalization 3 weeks earlier were now available and, interestingly, showed 2ϩ growth of Campylobacter jejuni, broadly sensitive to all antibiotics including penicillin. Piperacillin/tazobactam was started intravenously, and CT-guided drainage of the largest pus pocket was again performed.We carefully reexamined the patient's CT scan, and there appeared to be a lesion in the right main-stem bronchus. We decided to perform a bronchoscopy, which revealed a foreign body in the right main-stem bronchus. The foreign body turned out to be a piece of chicken and a peanut. On specific questioning of the patient again, he admitted that at times he coughed after eating too quickly. Specifically, he remembered that a few days C A S E R E P O R T

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CT virtual bronchoscopy in the evaluation of children with suspected foreign body aspiration

Cited by 127 publications

References 19 publications

An Interesting Case of Aspiration In a Patient With Asthma

An Interesting Case of Aspiration In a Patient With Asthma

Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho

Camplyobacter empyema due to food aspiration

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