Foreign Body Aspiration in Adults and in Children

Casalini, Angelo Gianni; Majori, Maria; Anghinolfi, Miriam; Burlone, Emanuela; D’Ippolito, Raffaele; Toschi, Marco; Pisi, Giovanna; Barantani, Daniele; Ghasempour, Davoud; Monica, Maurizio

doi:10.1097/lbr.0000000000000024

Cited by 34 publications

(15 citation statements)

References 8 publications

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“…About half of the patients have no history of acute aspiration or a visible foreign body in chest imaging. The manifestations are different in adults and in children, ( 1 – 3 , 5 , 7 , 8 )although some reports of adult patients also show similar results. ( 1 , 2 ) This is due to the larger diameter of the adult bronchus, which cannot be totally obstructed by a foreign body.…”

Section: Discussionmentioning

confidence: 87%

“…Foreign body aspiration into the lower airway is less likely in adults than in children. ( 1 – 8 ) Some adult patients have acute aspiration within one week but often have no acute symptoms that occur in children or infants. Others have no acute aspiration history within one month but may have only chronic cough without dyspnea, wheeze, or chest pain.…”

Section: Introductionmentioning

confidence: 99%

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Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults

et al. 2015

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ObjectivesAspiration of the lower airways due to foreign body is rare in adults. This study aimed to determine the outcome of patients who received flexible bronchoscopy with different modalities for foreign body removal in the lower airways.Patients and MethodsBetween January 2003 and January 2014, 94 patients diagnosed with foreign body in the lower airways underwent flexible bronchoscopy with different modalities, which included forceps, loop, basket, knife, electromagnet, and cryotherapy. The clinical presentation, foreign body location and characteristics, and applications of flexible bronchoscopy were analyzed.ResultsForty (43%) patients had acute aspiration, which developed within one week of foreign body entry and 54 (57%) had chronic aspiration. The most common foreign bodies were teeth or bone. More patients with chronic aspiration than those with acute aspiration were referred from the out-patient clinic (48% vs. 28%), but more patients with acute aspiration were referred from the emergency room (35% vs. 6%) and intensive care unit (18% vs. 2%). Flexible bronchoscopy with different modalities was used to remove the foreign bodies (85/94, 90%). Electromagnet or cryotherapy was used in nine patients to eliminate the surrounding granulation tissue before foreign body removal. In the nine patients with failed flexible bronchoscopy, eight underwent rigid bronchoscopy instead and one had right lower lung lobectomy for lung abscess.ConclusionsFlexible bronchoscopy with multiple modalities is effective for diagnosing and removing foreign bodies in the lower respiratory airways in adults, with a high success rate (90%) and no difference between acute and chronic aspirations.

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Section: Discussionmentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults

et al. 2015

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“…[12] However, occasional patients may present with acute symptoms such as stridor, cough, wheeze, and respiratory failure in cases of a large FB that is located in the proximal airways. [1314] This was also highlighted in the index case that presented with acute symptoms and was found to have a large FB in the left main bronchus.…”

Section: Discussionmentioning

confidence: 71%

“…[1] However, in certain situations as mentioned before, rigid bronchoscopy is preferred. [1214] In our patient, the FB was large and could not be grasped easily with the small shark tooth forceps or the Dormia basket during flexible bronchoscopy.…”

Section: Discussionmentioning

confidence: 85%

Use of cryoprobe for removal of a large tracheobronchial foreign body during flexible bronchoscopy

et al. 2016

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Foreign body (FB) inhalation in the tracheobronchial tree is an infrequently encountered event in adults. The diagnosis is suspected in the presence of a clinical history of aspiration and the presence of respiratory symptoms. Management involves confirmation by flexible bronchoscopy, which may be both diagnostic as well as therapeutic. However, in certain situations including those with large FB, FB embedded in granulation tissue or FB with very smooth margins, rigid bronchoscopy may be superior to flexible bronchoscopy in the retrieval of the FB. An alternative to rigid bronchoscopy in such situations may be the use of a cryoprobe. Herein, we describe a patient with a large tracheobronchial FB causing a complete collapse of the left lung and hypoxemia. The FB was successfully extracted using a cryoprobe during flexible bronchoscopy, obviating the need for rigid bronchoscopy.

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“…Laryngeal and subglottic/tracheal FBs need urgent intervention, whereas more commonly the clinical situation is relatively stable. However, even in stable patients with distal obstruc-tions, the possibility of increased morbidity due to prolonged distal obstruction as well as the potential for a FB to dislodgement, should be taken into consideration when planning the timing of removal [14,15].…”

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confidence: 99%

Inhaled Foreign Bodies

Majori

2015

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Foreign Body Aspiration in Adults and in Children

Abstract: We conclude that an efficient organization involving a dedicated protocol of intervention, trained staff available 24 hours a day, 7 days a week, appropriate setting, and the right instrumentation enabled us to tackle this important emergency.

Cited by 34 publications

References 8 publications

Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults

Flexible Bronchoscopy with Multiple Modalities for Foreign Body Removal in Adults

Use of cryoprobe for removal of a large tracheobronchial foreign body during flexible bronchoscopy

Inhaled Foreign Bodies

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