Management of tracheobronchial foreign body in children

Abstract

To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at São Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.

Cuerpo extraño bronquial: Experiencia de los últimos 18 años en Hospital Guillermo Grant Benavente, Concepción, Chile

“…La falla en el diagnóstico de CEVA se ha reportado entre 20%-25% según dos grandes casuísticas [7][8] . En nuestra revisión el 29,8% de los casos consultó más de una vez previo al diagnóstico de CEVA, y sólo en el 53% de los casos el diagnóstico se realizó dentro de las primeras 24 horas.…”

“…El éxito de la extracción mediante la BR fue de 96,8% lo cual está acorde con la literatura [1][2][3]7,8,[14][15][16] . Por fortuna no tuvimos complicaciones relevantes.…”

A university experience in foreign body aspiration

“…Aspirasyonun tanısında direkt radyografiler önemli bir yer tutar. Grafilerde tek taraflı havalanma fazlalığı, atelektazi ve yabancı cisim saptanabilir, radyografinin %20-50 oranında normal olabileceği unutulmamalıdır (3,12,13 Resim 2. Toplu iğne yutan bir hastanın arka-ön ve yan akciğer grafisi.…”

Tracheabronchial Foreign Bodies Aspirations in Adults: Two Cases Report

“…[5,6] PA akciğer grafilerinde %25'e varan normal görünüm bildirilmiştir. [7] Her iki olguda da YCA açısından radyolojik bir bulguya rastlanmadı. Anamnez ve fizik muayene bulguları göz önünde tutularak tanı ve tedaviye gidildi.…”