Aerodigestive Foreign Bodies in Adult Ethiopian Patients: A Prospective Study at Tikur Anbessa Hospital, Ethiopia

Abstract

Introduction. Foreign bodies (FBs) in the aerodigestive tract are important causes of morbidity and mortality and pose diagnostic and therapeutic challenges. The best method of removal of an esophageal and tracheobronchial FB is endoscopic guided extraction. Objective. To present our experience of the removal of aerodigestive FBs in adult Ethiopian patients using rigid endoscopes. Methods. A hospital-based prospective study, at Tikur Anbessa Referral and Teaching Hospital, from January 2011 to December 2012 (over two years). Results. A total of 32 patients (18 males and 14 females) with a mean age of 28.0 ± 12.74 years were treated for FB ingestion and aspiration at Tikur Anbessa Hospital. The FBs were impacted at the esophagus in 18 (56.2%) patients, at the pharynx in 7 (21.8%), and at the air way in 7 (21.8%) patients. Pieces of bones were the commonest objects found in the esophagus (17/18 of the cases) and the pharynx (4/7), while fractured tracheostomy tubes and needles were frequently seen in the air way (3/7 cases each). The foreign bodies were visible in plain radiographs of 26 (81.2%) patients. Successful extraction of FBs was achieved by using Mc gill forceps in 11 cases, rigid esophagoscopes in 9 patients, and bronchoscopes in 4 cases. Four cases required open surgery to remove the foreign bodies. Two complications (one pneumothorax and one esophageal perforation) occurred. All patients were discharged cured. Discussion and Recommendations. Aerodigestive FBs are not so rare in the hospital and timely diagnosis and removal of accidentally ingested and aspirated foreign body should be performed so as to avoid the potentially lethal complications associated. Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but our experience and outcome of its use are encouraging.

Analysis of ingested foreign bodies according to age, type and location: a retrospective observational study

“…They were the most common type of foreign body in all age groups, and fish bones were most commonly located in the tonsils (48.5%) (Table ). This high rate of fish bone ingestion is in agreement with several previous studies reporting variable rates of fish bone ingestion of up to 90.4%, although some studies identified other types of foreign bodies as the most frequent, including a study of coin ingestion by children . The types of foreign bodies ingested were influenced by differences in the characteristics of the study groups, such as age and dietary habits.…”

Aspiration of hijab pin is sharply rising among young women---A preventable health problem

“…[5] Bronchoscopy is the treatment modality of choice and surgery is rarely required. [4] Pearl head pins behave as floating objects, mobile in nature especially in the early phase of inhalation and initial immediate preoperative X-rays are beneficial.…”

“…[13] Rigid esophagoscopy requires general anesthesia and is associated with its own complications, but experience and outcome of its use are generally encouraging. [5]…”

“…Foreign bodies in the aerodigestive tract are important causes of morbidity and mortality and postdiagnostic and therapeutic challenges. [5] Recently, there has been an increase in trends of aspiration and ingestion of sharp foreign body (pins) due to headscarf particularly in Muslim girls who have the habit of holding the pin between their lips or teeth, to get a free hand while doing or undoing their headscarf. The beaded end of the pins is heavier than the rest of the pin and therefore the pin usually falls with beaded end pointing downwards.…”

Incidence and management of foreign bodies in aerodigestive tract in a tertiary level

“…There have also been studies on ways of improving the management outcomes [8][9][10][11]. In the present study, we studied prospectively the pattern of presentation of patients in a single institution with FB inaerodigestive tract and incidence of intra-operative complications following rigid esophagoscopy/ bronchoscopy and the incidence of successful outcome after this procedure.…”