Tracheobronchial foreign bodies

Ja, Nakhosteen

doi:10.1183/09031936.94.07030429

Cited by 33 publications

(15 citation statements)

References 7 publications

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“…3,6,10,28,30,[35][36][37] However, there are situations in which flexible bronchoscopy is unsuccessful in foreign body extraction, including foreign bodies that are impacted in extensive granulation tissue or excessive tissue scarring, a large foreign body that cannot be gripped with flexible forceps, asphyxiating foreign bodies, foreign bodies with a smooth margin, sharp foreign bodies, and several failed attempts by flexible bronchoscopy to retrieve a foreign body. 38 In these cases, rigid bronchoscopy remains the procedure of choice (Table 3). 3,4,6,10,14,22,23,25,35 A variety of instruments are used during flexible bronchoscopy to extract a foreign body, such as grasping for- ceps or Dormia basket, depending on the nature of the foreign body.…”

Section: Discussionmentioning

confidence: 99%

Foreign Body Inhalation in the Adult Population: Experience of 25,998 Bronchoscopies and Systematic Review of the Literature

et al. 2015

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BACKGROUND: Foreign body aspiration is an uncommon entity in adults. Herein, we describe our experience with flexible bronchoscopy in the removal of tracheobronchial foreign bodies in adults. We also conducted a systematic review of the literature on the topic of foreign body inhalation in adults managed with flexible bronchoscopy. METHODS: The bronchoscopy database (from 1979 to 2014) was reviewed for subjects > 12 y of age with a history of foreign body aspiration managed with flexible bronchoscopy. Demographic, clinical, and bronchoscopy data were collected and analyzed. PubMed was reviewed for studies describing the use of flexible bronchoscopy for foreign body extraction in adults. RESULTS: During the study period, a total of 25,998 flexible bronchoscopies were performed. Of these, 65 subjects (mean age of 32.8 y, 49 males) were identified who had undergone bronchoscopy for foreign body aspiration. Nonresolving pneumonia (30.6%), direct foreign body visualization (24.6%), and segmental collapse (18.4%) were the most common radiological abnormalities. Foreign bodies were identified in 49 cases during bronchoscopy and successfully removed in 45 (91.8%) subjects with no major complications. Metallic (41%) and organic (25.6%) foreign bodies were the most common. Shark-tooth (44.9%) and alligator (32.6%) were the most commonly used forceps in retrieving the foreign bodies. The systematic review yielded 18 studies (1,554 subjects with foreign body inhalation). In adults, the proportion of flexible bronchoscopy (6 studies, 354/159,074 procedures) performed for the indication of foreign bodies among the total flexible bronchoscopies was 0.24% (95% CI 0.18 -0.31). The overall success of flexible bronchoscopy (18 studies, 1,185 subjects) for foreign body extraction was 89.6% (95% CI 86.1-93.2). CONCLUSIONS: Foreign body aspiration is a rare indication for flexible bronchoscopy in adults. Flexible bronchoscopy has a high success rate in removal of inhaled foreign body and can be considered the preferred initial procedure for management of airway foreign bodies in adults.

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Section: Discussionmentioning

confidence: 99%

Foreign Body Inhalation in the Adult Population: Experience of 25,998 Bronchoscopies and Systematic Review of the Literature

et al. 2015

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“…It is the procedure of choice to identify and remove the object due to its better control of the airway, allowing good visualization and manipulation. 22,[25][26][27] In our institution, all cases of foreign body aspiration were extracted using rigid bronchoscopy. Flexible bronchoscopy is also advocated by some author sand complication rate reported to be as low as 0.3% versus 1.1% from rigid bronchoscopy.…”

Section: Discussionmentioning

confidence: 99%

Foreign bodies in aero-digestive tract in children: spectrum of presentation and management

Patil¹,

Prakash

2017

Int Surg J

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INTRODUCTIONForeign body (FB) ingestion and aspiration is quite common in children. It is a life-threatening condition. In any child presenting with sudden history of respiratory distress and associated decreased chest movement and air entry on the affected side, FB aspiration should be strongly suspected. Even the absence of signs and symptoms does not rule out FB especially when there is positive history of FB ingestion present. Early diagnosis of foreign body aspiration is essential as delay in its recognition and treatment results in multitude of complications.1 Nevertheless, clinical presentation of aspiration can be subtle, mimicking other respiratory conditions, resulting in mismanagement.2,3 High index of suspicion is the cornerstone of diagnosis. Emergency surgery is life saving and also decreases mortality and morbidity. ABSTRACTBackground: Foreign body (FB) ingestion and aspiration is quite common in children. It can be a life-threatening condition. Early diagnosis of foreign body aspiration is essential as delay in its recognition and treatment results in high morbidity and mortality. Symptoms seem to mostly depend on the anatomical location. The absence of specific symptoms indicating the occurrence of FB injury can lead to delay in diagnosis, thereby increasing the risk of complications. Methods: This is a prospective study which comprised of 50 patients with between 8 months and 4.5 years. FB involving different parts of the aero-digestive tract were included in the study. The site, side, symptoms and radiographic findings were recorded for each patient. Different procedures were used for retrieval of various FB at different locations. Majority of these procedures were performed under anaesthesia. Results: Most of the FB were organic in nature. Right side bronchus was more commonly involved. A combination of different procedures was used according to the site involved. All the FB were removed successfully and smoothly. There was minimum morbidity with no mortality and the overall outcome was excellent. Hospital stay varied according to the site of involvement. Conclusions: The symptoms of FB change with the site involved and many patients are even asymptomatic. A differential diagnosis of foreign body should always be made in an acute or chronic presentation of respiratory cases. Aspiration of foreign body should be suspected in all cases of broncho-pulmonary infection with atypical course. High index of suspicion is the cornerstone of diagnosis. Bronchoscopy is the best diagnostic and therapeutic method in all suspicions of foreign body of tracheo-bronchial tree. Proper and timely intervention optimizes the outcome.

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“…Tracheobronchial foreign body aspirations in adults are not common [4][5][6], and tend to be non-asphyxiating in nature. There is usually an underlying factor such as loss of the swallowing reflex either due to an abnormality in the reflex or a bypass of the reflex in the oropharynx.…”

Section: Discussionmentioning

confidence: 99%

What The Tooth Fairy Missed: An Unusual Cause of Recurrent Pneumonia and Successful Management with Fiberoptic Bronchoscopy

Kg¹,

Nongpiur²,

Warjri³

et al. 2017

JCR

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Background: Tracheobronchial aspiration is uncommon in adults. The non-asphyxiating nature of such lesions usually leads to chronicity and an obscure clinical presentation that is often confused with chronic respiratory disorders such as asthma, recurrent pneumonia. A high index of clinical suspicion is imperative in the diagnosis. Case Report: We present a case of an aspirated tooth that masqueraded as recurrent pneumonia for more than two years prior to its successful removal by fiberoptic bronchoscopy. Conclusion: Adult tracheobronchial aspirations can present with chronic respiratory symptoms, high index of suspicion is needed and prompt bronchoscopic removal is the treatment of choice.

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Tracheobronchial foreign bodies

Cited by 33 publications

References 7 publications

Foreign Body Inhalation in the Adult Population: Experience of 25,998 Bronchoscopies and Systematic Review of the Literature

Foreign Body Inhalation in the Adult Population: Experience of 25,998 Bronchoscopies and Systematic Review of the Literature

Foreign bodies in aero-digestive tract in children: spectrum of presentation and management

What The Tooth Fairy Missed: An Unusual Cause of Recurrent Pneumonia and Successful Management with Fiberoptic Bronchoscopy

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