scholarly journals Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of flexible bronchoscopy and urology stone retrieval basket in emergency setting

2021 ◽  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Pediatric Population ◽  
Operation Time ◽  
Operative Management ◽  
Flexible Bronchoscopy ◽  
Emergency Setting ◽  
Flexible Bronchoscope ◽  
Pediatric Airway

Objective: Tracheobronchial aspiration of foreign body in children is an emergency that can lead to major complications. In the last years flexible bronchoscopy has gained popularity for foreign bodies retrieval in the pediatric population, yet the small size of the pediatric airway and of the flexible bronchoscope channel limit the availability of instruments during the procedure. Aim of this paper is to describe our experience in treating foreign bodies tracheobronchial aspiration in children aged 2 years or less by means of flexible bronchoscope and an urology stone retrieval basket. Methods: A review of endoscopic foreign bodies removal by means of flexible bronchoscopy and urology stone retrieval basket has been carried out in children ≤ 2 years that presented at the Emergency Room of our hospital from 2005 to 2019. In the paper, we analyze characteristics of patients, timing of bronchoscopy, instruments and operative management. Results: There were 25 patients with a mean age of 20 ± 3.8 months. Organic material was the most frequent observed foreign body. Association of main bronchus and distal bronchi was the preferred site of the foreign body in 19 patients and the right side of the bronchial tree was involved in 17 cases. Complications occurred in one case. Mean operation time was 37 ± 20 minutes. Conclusions: The use of flexible bronchoscope can be helpful in handling endoscopic removal of tracheobronchial foreign bodies in toddlers. The use of the urology stone retrieval basket resulted very effective in all shapes of foreign bodies and/or when the object was located in the distal bronchi.

scholarly journals FOREIGN BODY BRONCHUS PRESENTING WITH PLEURAL EFFUSION –A RARE PRESENTATION

2017 ◽  
Vol VOLUME 5 (VOLUME 5 NUMBER 2 JULY 2017) ◽  
pp. 18-20
Author(s):  
Sanjay Kumar
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Lower Lobe ◽  
Intrathoracic Pressure ◽  
The Elderly ◽  
Lung Parenchyma ◽  
Rigid Bronchoscopy ◽  
Flexible Bronchoscopy ◽  
Rare Presentation ◽  
Flexible Bronchoscope

INTRODUCTION: Aspirated foreign bodies most commonly are lodged in the right main stem and lower lobe. Aspiration has been documented in all lobes, including the upper lobes, though with less frequency.1-4 CASE REPORT: A 28 year old female presented with the chief complaints of shortness of breath since 15 days, cough with expectoration since 15 days, chest pain since 15 days. On examination the trachea was shifted to left side, bilateral chest movements were unequal with reduced chest movement on right side, tenderness was present on right side of chest. Chest X-Ray showed right sided hydropneumothorax. On flexible bronchoscopy Right bronchus intermedius showed foreign material. Foreign body removal under general anesthesia was done by rigid bronchoscopy. DISCUSSION: Unlike foreign-body aspiration in young children and in the elderly, this occurence is uncommon in adults. The availability of both rigid and flexible bronchoscopy should be emphasized since larger aspirates may not be retrievable with a flexible bronchoscope. Surgery constitutes the final, definitive option and is generally well tolerated, particularly when the lung parenchyma is spared.5-7 This case emphasizes the fact that healthy adults may tolerate aspiration of foreign bodies for a long time without acute life-threatening consequences.5-8 The exact mechanism is not known. The possible mechanisms are either it may be a result of an inflammatory response to a foreign body in the bronchus or it is secondary to the atelectasis and the sudden morenegative intrathoracic pressure.9-11

scholarly journals Endobronchial Foreign Body Presenting as Exacerbation of Asthma

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
James E. Tsang ◽  
June Sun ◽  
Gaik C. Ooi ◽  
Kenneth W. Tsang
Keyword(s):  
Foreign Body ◽  
Respiratory Distress ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Fiberoptic Bronchoscopy ◽  
Clinical History ◽  
Medical Personnel ◽  
History Of ◽  
Normal Chest ◽  
Low Dose Computed Tomography

Airway foreign bodies are a leading cause of death among children and require urgent recognition by medical personnel. While most cases are diagnosed readily from a clinical history of acute respiratory distress, some cases remain more indolent and present later. We report the case of a 7-year-old boy who aspirated a “LEGO” toy and presented with a week history of increasing respiratory distress compatible with known asthma. Despite a normal chest X-ray, a low-dose computed tomography showed the presence of a foreign body in the left main bronchus, which was subsequently removed by fiberoptic bronchoscopy. Our case serves to reemphasize the importance of considering airway foreign bodies as a cause of respiratory distress, especially in young children.

Foreign Body Aspiration: Potential Cause of Coughing and Wheezing

1988 ◽  
Vol 10 (2) ◽  
pp. 59-63
Author(s):  
H. James Holroyd
Keyword(s):  
Foreign Body ◽  
Respiratory Symptoms ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Congenital Defects ◽  
Natural Tendency ◽  
History Of ◽  
Possible Cause ◽  
Cardiopulmonary System ◽  
Infants And Young Children

As many as half of routine ill-patient visits in pediatrics practice involve respiratory symptoms. It is not surprising that we see so much coughing and wheezing when we consider that children are still developing immunologically and are, therefore, more susceptible to infection. In early life, most of these infectious diseases occur in the respiratory and gastrointestinal tracts. In addition, the gradual exposure of the constitutionally allergic child to environmental allergens pre-disposes to the development of respiratory symptoms. Childhood is also a time for congenital defects of the cardiopulmonary system to become apparent. A sometimes overlooked cause of respiratory symptoms in infants and young children—and one that can become rapidly and severely complicated if misdiagnosed—is the aspiration of foreign bodies. Aspiration or ingestion of foreign bodies remains a significant cause of morbidity and mortality in the pediatric population. Children between 8 months and 4 years of age are at highest risk. Not all cases of aspiration are of the acute, obstructive variety, and pediatricians should consider a foreign body as a possible cause of coughing and wheezing even when no definite history of aspiration is obtained. Children of course are curious and their natural tendency is to reach out and explore new objects. Bringing objects to their mouths to taste and to test textures is common.

scholarly journals Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

2021 ◽  
Author(s):  
Anastasios-Panagiotis Chantzaras ◽  
Panagiota Panagiotou ◽  
Spyridon Karageorgos ◽  
Konstantinos Douros
Keyword(s):  
Systematic Review ◽  
Foreign Body ◽  
Pediatric Population ◽  
Bronchial Tree ◽  
Tracheobronchial Tree ◽  
Flexible Bronchoscopy ◽  
Safe Alternative ◽  
Gold Standard Method ◽  
Foreign Body Removal ◽  
The Right

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

scholarly journals Risk Management and Recommendations for the Prevention of Fatal Foreign Body Aspiration: Four Cases Aged 1.5 to 3 Years and Mini-Review of the Literature

2020 ◽  
Vol 17 (13) ◽  
pp. 4700
Author(s):  
Angelo Montana ◽  
Monica Salerno ◽  
Alessandro Feola ◽  
Alessio Asmundo ◽  
Nunzio Di Nunno ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Foreign Body Aspiration ◽  
Health Concern ◽  
Upper Airways ◽  
Significant Public Health Concern ◽  
Correct Execution ◽  
Significant Public Health ◽  
Free Environment

(1) Background: Foreign body aspiration (FBA) is a significant public health concern among the pediatric population, and fatalities are dramatic for families. It typically involves organic foreign bodies (mainly food) aspirated by children under three years old, usually at home or school. This review aimed to focus on the preventive measures around four actual cases of fatal foreign body aspiration, emphasizing the correct execution of the Heimlich maneuver and cardiopulmonary resuscitation, supervised mealtimes, and high-risk foods. (2) Methods: Four fatal cases of foreign body aspiration in children are presented here. The children were in a free environment, such as school, home, and the countryside, and were in the presence of teachers, parents, and a grandmother who did not supervise the children adequately. A literature review was performed via the MEDLINE database using the key terms: “foreign body aspiration,” “infant choking, 1.5 to 3 years,” “food and foreign body aspiration,” “common household,” “prevention of foreign body aspiration,” “guidelines,” “recommendations,” “training of caregivers (parents, educators),” “resuscitation,” “Heimlich maneuver,” and “disengagement of the upper airways.” We focused on the prevention of foreign body aspiration. (3) Results: a complete postmortem examination was performed. In three cases, the foreign bodies were food (mozzarella cheese, pear, or raw bean), while in one case, the foreign body was a pebble. (4) Conclusions: This review aimed to discuss recent scientific literature and provide a perspective on the benefits of a dedicated approach to the management of fatal foreign body aspiration in children by caregivers who usually have no experience with the best ways of supervising children in a safe environment, especially regarding the correct execution of resuscitation maneuvers, such as the Heimlich maneuver. Recommendation updates could improve healthcare quality in a pediatric setting and reduce medico-legal implications.

Utility of Conventional Radiography in the Diagnosis and Management of Pediatric Airway Foreign Bodies

1998 ◽  
Vol 107 (10) ◽  
pp. 834-838 ◽  
Author(s):  
Andrew B. Silva ◽  
Harlan R. Muntz ◽  
Randall Clary
Keyword(s):  
Foreign Body ◽  
Physical Examination ◽  
Foreign Bodies ◽  
Surgical Intervention ◽  
Operative Intervention ◽  
Radiographic Imaging ◽  
Pediatric Airway ◽  
Diagnosis And Management ◽  
Breath Sounds ◽  
Airway Foreign Body

Pediatric airway foreign bodies are potentially life-threatening situations. The otolaryngologist is often consulted to aid in the diagnosis and management of these difficult cases. Although radiographic studies are often obtained, the decision for surgical intervention is usually based on a suspicious history and physical examination. Our hypothesis is that radiographic imaging should not alter the decision for surgical intervention. We retrospectively reviewed the cases of pediatric airway foreign bodies managed by the otolaryngology department at St Louis Children's Hospital between December 1990 and June 1996 with both radiographic imaging and operative intervention. Ninety-three cases of potential aspiration were identified, with a median patient age of 20 months. The most common presenting signs and symptoms were aspiration event (n = 82), wheezing (n = 76), decreased breath sounds (n = 47), cough (n = 39), respiratory distress (n = 17), fever (n = 16), pneumonia (n = 14), and stridor (n = 7). At the time of endoscopy, 73 patients were found to have an airway foreign body. The sensitivity and specificity of the imaging studies in identifying the presence of an airway foreign body in the 93 patients were 73% and 45%, respectively. Our decision for operative intervention was based on the history and physical examination, and was not changed in the presence of a negative radiographic study. The routine use of radiography should not alter the management of airway foreign bodies, providing that there is a well-equipped endoscopic team familiar with airway foreign bodies.

scholarly journals Unusual case of mobile phone simulation SIM card’s outer case ingestion: wedged at laryngeal surface of epiglottis

2019 ◽  
Vol 5 (2) ◽  
pp. 514
Author(s):  
Rachna Dhingra ◽  
Jai Lal Davessar ◽  
Shruti Sharma ◽  
Kanwalpreet Kaur
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Mobile Phone ◽  
Unusual Case ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Title Page ◽  
Common Occurrence ◽  
Accidental Ingestion ◽  
Emergency Department Attendance

<div class="page" title="Page 2"><div class="layoutArea"><div class="column"><p class="abstract">Accidental ingestion of foreign bodies in the pediatric population is usually small pieces from toys or other household objects and subsequent emergency department attendance is a common occurrence. Here we describe an unusual case of accidental swallowing where the foreign body is outer case of mobile phone simulation (SIM) card.</p></div></div></div>

scholarly journals A unique foreign body in bronchus: surgical challenge

1970 ◽  
Vol 17 (2) ◽  
pp. 132-134
Author(s):  
Bharti Solanki ◽  
Govind Narayan Purohit
Keyword(s):  
Foreign Body ◽  
Key Words ◽  
Present Article ◽  
Gold Standard ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Bronchial Tree ◽  
Key Words Foreign Body ◽  
Glass Bulb

Exogenous foreign bodies in tracheo bronchial tree are not uncommon, particularly in children. The gold standard principal of foreign body management is bronchoscopic removal and this procedure becomes difficult and challenging in cases of large and smooth foreign body as occur in our case. The present article reports a case of unique and large foreign body i.e. intact glass bulb in right main bronchus. Key words: Foreign body; Bronchus.DOI: http://dx.doi.org/10.3329/bjo.v17i2.8854 BJO 2011; 17(2): 132-134

scholarly journals Push Enteroscopy Guided Removal of a Sharp Foreign Body from the Midjejunum in a Child

2020 ◽  
Vol 11 (02) ◽  
pp. 170-172
Author(s):  
Sridhar Sundaram ◽  
Suprabhat Giri ◽  
Biswaranjan Patra ◽  
Harish Darak ◽  
Shobna Bhatia
Keyword(s):  
Small Intestine ◽  
Foreign Body ◽  
Foreign Bodies ◽  
Pediatric Population ◽  
Push Enteroscopy ◽  
Foreign Body Removal ◽  
Case Presentation ◽  
Resource Limited ◽  
Small Intestinal ◽  
Sharp Foreign Body

Abstract Background The majority of foreign bodies entering the small intestine are passed spontaneously. However, in case of a sharp object, its removal is an urgency due to a higher risk of intestinal perforation, and endoscopic intervention is an appropriate management strategy as surgery is associated with greater morbidity. Although enteroscopy is the standard practice for the removal of a foreign body in the small intestine, gastroduodenoscopy may be used for small intestinal foreign body removal. Case Presentation We describe here the case of a 21-month-old child in whom a 5-cm, sharp-pointed nail in the midjejunum was removed successfully by a gastroduodenoscopy. This case highlights the difficulties in the removal of a sharp foreign body in a pediatric patient and the use of push enteroscopy. Conclusion Gastroduodenoscopy can be used for the removal of a foreign body in the small intestine in pediatric population in a resource-limited setup by performing push enteroscopy.

scholarly journals Comparison of direct vision and video imaging during bronchoscopy for pediatric airway foreign bodies

2003 ◽  
Vol 82 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Cheng-Chien Yang ◽  
Kuo-Sheng Lee
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Direct Vision ◽  
Pediatric Airway ◽  
Video Imaging ◽  
Significant Difference ◽  
Positive Rate ◽  
The Difference ◽  
Videotape Recording ◽  
Second Procedure

Rigid ventilation bronchoscopy is a most useful means of detecting and removing foreign bodies in the airway. We performed a retrospective study of 114 children who had undergone such a procedure during a 12-year period. During bronchoscopy, 48 of these patients had been examined under direct vision and 66 by videotape recording. We found that the positive rate on first-look direct vision was 93.8% and the positive rate on first-look video imaging was 89.4%. The lower positive rate during the first-look examination by video imaging might be attributable to the facts that it is safer and that it provides a better visual field, which can encourage operators to choose video ventilation bronchoscopy, either as a diagnostic or therapeutic tool. In addition, three foreign-body-negative patients in the direct-vision group underwent a second procedure, and a foreign body was found in all three. Only one of the video-imaging patients underwent a second procedure, and no foreign body was found. The difference in the positive rates after the second procedure was statistically significant (p<0.05). This might be attributable to the higher success rate with video imaging following the first procedure, which significantly reduced the need for a second look and the possibility of overlooked or residual foreign bodies. The condition of the mucosa postprocedurally was described in every case after video imaging but after only 41.7% of the direct-vision cases—a statistically significant difference (p<0.001). Video imaging provides the physician with a clear, magnified view of the area under examination. It allows for later review of the videotape when necessary, and it reduces the risk that residual foreign-body material will remain in the airway.

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