Aspirated foreign bodies in children: why are they more commonly found on the left?

Looij, Marjolein A.J. van; Rood, P.P.M.; Hoeve, L.J.; Borgstein, Johannes

doi:10.1046/j.1365-2273.2003.00725.x

Cited by 34 publications

(28 citation statements)

References 5 publications

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“…1 Some of the common symptoms associated with foreign body inhalation include sudden onset of dyspnoea, stridor, irritating cough, choking symptom, and voice change especially in laryngeal foreign bodies. 2 Van Looij et al 5 in their review of aspirated foreign bodies in children noted that in children up to three years there was no significant difference in site of location of foreign bodies in the bronchi; however in children aged three or older foreign bodies were commonly found in the right main bronchus due to handling of choking infants by their parents.…”

Section: Introductionmentioning

confidence: 99%

Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital, Accra, Ghana

Kitcher¹

2010

West African Journal of Medicine

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BACKGROUND: Foreign body inhalation, a surgical emergency requiring prompt management to avoid morbidity and mortality , poses a diagnostic and management challenge to otolaryngologists. OBJECTIVE: To assess the pattern of foreign body inhalation at the ENT Unit Korle Bu Teaching Hospital Accra, Ghana. METHODS: The theatre records of patients managed for foreign body inhalation from Ist January 2003-31st December 2006 at the ENT Unit of the Korle Bu Teaching Hospital Accra, Ghana were studied with respect to age, sex, clinical presentation, types of foreign bodies removed, location of foreign bodies, and outcomes of the laryngoscopy or bronchoscopy procedures. RESULTS: There were forty patients with an age range of seven months to 15 years with a mean age of 4.78 years and a peak age incidence at zero-four year age group. The commonest inhaled foreign bodies included groundnuts in five (12.5%) patients, fish bones in six (15%) patients, plastic materials in five (12.5%) patients, metal material in five (12.5%) patients and seeds in five (12.5%) patients. The common clinical presentations included respiratory difficulty, irritating cough, choking, painful swallowing and whistling sound during breathing. Foreign bodies were localized in the right main bronchus in 27 (67.5 %) patients, and in the left main bronchus in ten (25%) patients and in the larynx in three (7.5%) patients. One patient died during bronchoscopy and another patient had bronchotomy for failed bronchoscopy.

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Section: Introductionmentioning

confidence: 99%

Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital, Accra, Ghana

Kitcher¹

2010

West African Journal of Medicine

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“…Aspire edilen yabancı cisimlerin vertikal pozisyonu nedeniyle genellikle sağ ana bronşa ilerlediği bilinmekteyken, türban iğnesi gibi keskin ve dar çaplı yabancı cisimlerin sol tarafa gitme ihtimali daha fazladır [5]. Gülme, öksürme, konuşma gibi eylemler sırasında oluşan negatif basınç etkisiyle ve daralan sol bronşun daha fazla emme gücü oluşturmasıyla bu tip cisimlerin sol bronşa gittiği görülür [6]. Yabancı cismin alımı sonrası aşırı bir öksürük şikâyetinin ardından sıklıkla asemptomatiktir [7].…”

Section: Discussionunclassified

Oh No! Pin Again! A Case of Foreign Body Aspiration

Güllüpınar¹,

Sarihan²,

Ersoy³

2015

Ann Clin Anal Med

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ÖzetTrakeobronşiyal sisteme yabancı cisim aspirasyonu ciddi ve ölümle sonuçlanabilen ve acil girişim gerektiren solunumsal acildir. Trakeabronşiyal yabancı cisim aspirasyonu erişkinlerde çocuklara kıyasla nadirdir. Yabancı cisim aspirasyonlarında en sık bulgu öksürüktür. Akciğer grafilerinde, radyoopak yabancı cisimler tespit edilebilir. Tanı konduktan sonra, yabancı cismin mümkün olduğunca erken çıkarılma-sı gerekmektedir. Çıkarılma işlemi, fleksibl fiberoptik bronkoskopi veya rijid bronkoskop ile yapılmaktadır. Yazımızda, acil servisimize türban iğnesi yutma şikayeti ile başvuran hastada direkt grafilerle görüntülenemeyen son teknoloji 3D yöntem-le görüntülenen türban iğnesi aspirasyonu olgusunu sunduk. Anahtar Kelimeler3D Bilgisayarlı Tomografi; Acil Bronkoskopi; İğne Aspirasyonu; Türban İğnesi Abstract Foreign body aspiration to tracheobronchial system is a serious respiratory emergency which requires emergency intervention and may result in death. Tracheobronchial foreign body aspiration is rare in adults in comparison with children. The most frequent symptom of foreign body aspiration is cough. Radio-opaque foreign bodies may be detected in relevant chest radiography. After the diagnosis is established, foreign body is to be taken out as immediate as possible. Take-out operation is conducted by flexible fiberoptic bronchoscopy or rigid bronchoscopy. In this paper, we present the case of turban pin aspiration detected on a patient, who applied to our emergency room with the complaint of turban pin swallowing, which could only be visualized by state-of-the-art technology 3D method not by direct graphies.

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“…During bronchoscopy, objects were found most often in the right main stem bronchus followed by the left, as in most surveys [7][8][9][10][11][12][13][14][15][16]]. An exception was found in two studies in which patients under 3 years of age inhaled FBs into the left bronchus slightly more frequently (51.4% and 55.0%) [17,18]. The authors explained this finding by the fact that they were carrying their child in the left arm while trying to assist them.…”

Section: Discussionmentioning

confidence: 99%

“…They stated that abnormalities were visible in only 122 of 232 plain CXRs [20]. In other surveys, focal hyperinflation or atelectasis was the most frequently appearing indirect radiological finding [16][17][18]. Shifting of the mediastinum and a raised dome of the hemidiaphragm are signs secondary to air trapping.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of paediatric airway foreign body: is it easy?

Rybojad¹,

Niedzielska

Rudnicka–Drożak

2014

Open Medicine

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AbstractForeign-body aspiration in children results in diagnostic problems, mainly because of nonspecific signs. Therefore, in this study, we placed particular stress on false-positive and -negative predictors. Charts of 139 consecutive paediatric patients aged 6.0 months to 15.5 years who underwent bronchoscopy for a suspected foreign body aspiration were analysed retrospectively. A foreign body was found in 95 cases (68%). The anamnesis was positive in 91%. Cough was the most common clinical symptom (91%) with a sensitivity and specificity of 94% and 23%, respectively. There were no significant correlations between clinical symptoms and the locations of foreign bodies. The majority of focal hyperinflation (24%) and atelectasis (15%) were seen in chest radiographs, with a sensitivity and specificity of 33% and 89% (hyperinflation) and 15% and 82% (atelectasis), respectively. Chest X-rays were normal in 46 cases; however, an object was removed in 25. Persistent infiltrates were present in 14 X-rays, and a foreign body was extracted during bronchoscopy in 4. A highly significant correlation between the type of foreign body and radiological signs was noted (p = 0.00001). Anamnesis, clinical symptoms, and radiological findings are helpful in confirming aspiration, but can be misleading. Chronic or recurrent pneumonia should prompt further bronchoscopic diagnosis.

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Aspirated foreign bodies in children: why are they more commonly found on the left?

Cited by 34 publications

References 5 publications

Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital, Accra, Ghana

Foreign Body Inhalation: A Review of Patients at the Korle Bu Teaching Hospital, Accra, Ghana

Oh No! Pin Again! A Case of Foreign Body Aspiration

Diagnosis of paediatric airway foreign body: is it easy?

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