Foreign body aspiration in children: diagnostic and therapeutic role of bronchoscopy

Korlacki, Wojciech; Korecka, Klaudia; Dzielicki, Józef

doi:10.1007/s00383-011-2874-8

Cited by 69 publications

(80 citation statements)

References 19 publications

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“…(6,7) Regardless of the equipment used, bronchoscopy should be performed in all cases of suspected FB aspiration, even if the radiological findings are normal. (8,9) In our series of patients, 25% of the chest X-ray findings were normal, despite a clinical history of FB aspiration.…”

Section: Discussionmentioning

confidence: 61%

“…(3,16) Virtually all aspirated FBs can be extracted by bronchoscopy, with success rates above 98%. Rigid bronchoscopy remains the standard procedure for the removal of FBs (9,17) and has various advantages over flexible bronchoscopy. Rigid bronchoscopes are larger in diameter than are flexible bronchoscopes, therefore allowing blood aspiration, thick secretion aspiration, and patient ventilation.…”

Section: Methodsmentioning

confidence: 99%

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Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos

et al. 2012

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Objective: To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults. Methods: This was a retrospective study of all adult patients (over 18 years of age) with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of São Paulo School of Medicine Hospital das Clínicas, located in São Paulo, Brazil. Results:The study sample comprised 40 adult patients, with a mean age of 52 years (range, 18-88 years). The median time of permanence of the foreign body in the airway was 15 days (range, 12 h to 10 years). All of the patients first underwent diagnostic flexible bronchoscopy. Foreign bodies were successfully removed with flexible bronchoscopy in 33 (82.5%) of the patients. In 1 patient, a metal object lodged in the distal bronchial tree required the use of fluoroscopy. Six patients (15%) required rigid bronchoscopy due to tracheal foreign bodyinduced dyspnea, in 2, and because the foreign body was too large for the flexible forceps, in 4. Bronchoscopy failed in 1 patient, who therefore required surgical bronchotomy. Conclusions: Although rigid bronchoscopy is considered the gold standard for the removal of foreign bodies from the airways, our experience showed that flexible bronchoscopy can be safely and effectively used in the diagnosis and treatment of stable adult patients.Keywords: Bronchoscopy; Foreign bodies; Airway obstruction; Airway management. ResumoObjetivo: Determinar a taxa de sucesso da broncoscopia flexível como primeira opção na remoção de corpos estranhos das vias aéreas em adultos. Métodos: Estudo retrospectivo de todos os pacientes adultos (acima de 18 anos) com aspiração de corpo estranho submetidos à broncoscopia no Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, em São Paulo (SP). Resultados: A amostra foi constituída por 40 pacientes adultos, com média de idade de 52 anos (variação: 18-88 anos). A mediana do tempo de permanência do corpo estranho na via aérea foi de 15 dias (variação: 12 h a 10 anos). Todos os pacientes foram submetidos primeiramente a broncoscopia flexível diagnóstica. A retirada do corpo estranho por meio de broncoscopia flexível foi bem-sucedida em 33 dos pacientes (82,5%). Em 1 paciente, um objeto metálico alojado na árvore brônquica distal requereu o uso de fluoroscopia. Seis pacientes (15%) foram submetidos à broncoscopia rígida devido a dispneia induzida por corpo estranho traqueal, em 2, e porque o corpo estranho era muito grande para as pinças flexíveis, em 4. A broncoscopia falhou em apenas 1 paciente, que portanto necessitou de broncotomia cirúrgica. Conclusões: Embora a broncoscopia rígida seja considerada o padrão ouro na remoção de corpos estranhos na via aérea, nossa experiência mostrou que a broncoscopia flexível pode ser utilizada segura e eficientemente no diagnóstico e tratamento de pacientes adultos estáveis.Descritores: Broncoscopia; Corpos estranhos; Obstrução das vias respiratórias; Manuse...

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Section: Discussionmentioning

confidence: 61%

Section: Methodsmentioning

confidence: 99%

Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos

et al. 2012

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“…In a study by Joseph et al in Arizona, United States, nails and screws (6.41 %) were the most common radiopaque FBs [22], while Lan-Fang et al in a 2009 study [23] of 1,027 children in Hangzhou, China, report 6.62 % radiopaque objects, comprising Fish bones in 27 cases (2.6 %) and pig bones in 22 cases (2.1 %). In Wojciech et al's study in 2011 in Poland, radiopaque bodies constituted 7.14 %, all of which were made of metal [24]. 4.34 % of total FBs aspirated in a 2012 study by Budensab noted a majority of coins among radiopaque objects [25].…”

Section: Resultsmentioning

confidence: 99%

25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

Saki

Nikakhlagh

Heshmati

2014

Indian J Otolaryngol Head Neck Surg

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This study was conducted to review the abundance and diversity of radiopaque foreign bodies over a 25-year period. Overall records of 1,114 patients who underwent rigid bronchoscopy due to foreign body aspiration in the tertiary centres, Imam Khomeini and Apadana; over a 25-year period (1989-2014) were reviewed. History, clinical findings, plain radiography and bronchoscopic findings, foreign body (FB) aspiration (whether radiolucent or radiopaque), time from onset of symptoms until hospitalization, and delay time were all considered. The male/female ratio was 1.53. Most patients were aged 1-3 years (53.94 %). The most common location of foreign bodies was the right main bronchus (54.57 %). The most common type of radiopaque foreign body was meat, chicken and big fish bones (4.84 %) followed by metal objects (4.39 %). Coughing (70.82 %) and cyanosis (22.80 %) were the most common symptoms. The most common radiological findings were emphysema (32.31 %). Given that the radiological findings are highly specific as regards the detection of radiopaque FB, radiographic examination prior to bronchoscopy for FB localization and shortening the time of bronchoscopy in patients with a history of radiopaque FB aspiration can be helpful. Due to the high morbidity and mortality caused by prolong and repeated bronchoscopy, the use of newer techniques and equipment in shortening extraction time of the foreign bodies should be considered in future researches.

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“…Daha komplike tablolarda ise pnömotoraks, subkütan amfizem ve pnömomediastinum görülebilir. Ayırıcı tanı mutlaka göğüs hastalıkları uzmanı ve göğüs cerrahisi uzmanı ile yapılmalıdır 4,20,22 .…”

Section: Arşiv Kaynak Tarama Dergisi Archives Medical Review Journalunclassified

Çocuklarda Trakeobronşial Sistemdeki Yabancı Cisimleri Çıkarmada Anestezi Uygulaması

Öç¹,

Arun²,

Öncel³

et al. 2014

Arşiv Kaynak Tarama Dergisi

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Foreign body aspiration is a real emergency for chidlren. Mortality and morbidity rates are directly correlated with clinical symptoms present during admission. The patients may present with a range of symptoms from cardiopulmonary arrest to mild respiratory symptoms without an apparent history of foreign body aspiration. This may lead to delays in diagnosis for several weeks or months which may further worsen lung problems. Chest X-ray or high-resolution computed tomography in the diagnosis phase could be beneficial. Bronchoscopy is used for both confirming the diagnosis and removing the obstruction in airways. Although there is no consensus on which method should be used during these procedures, pharmacological and technical advances in the field of anesthesia has lead to significant decrease in morbidity and mortality. The ventilation and anesthesia methods that would be applied largely depend on the cooperation and compliance between bronchoscopy user and anesthetist. In this article, anesthetic management used to remove foreign bodies in children to remove airway obstructions has been briefly reviewed. Key words: Tracheobronchial foreign bodies, method, anesthesia. ÖZETYabancı cisim aspirasyonları çocukluk döneminin gerçek acil vakaları arasında yer almaktadır. Mortalite ve morbidite oranları girişim öncesi çocuğun kliniğe başvurusunda var olan semptomları ile doğrudan ilişkilidir. Anestezi uygulamasında kardiyopulmoner arrestten, sadece yabancı cisim aspirasyonu hikayesi olmayan hafif respiratuar semptomlara kadar değişen klinikle karşımıza

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Foreign body aspiration in children: diagnostic and therapeutic role of bronchoscopy

Cited by 69 publications

References 19 publications

Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos

Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos

25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

Çocuklarda Trakeobronşial Sistemdeki Yabancı Cisimleri Çıkarmada Anestezi Uygulaması

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