Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children

Wang, Gang; Pan, Zhengxia; Li, Hongbo; Li, Yonggang; Dai, Jiangtao; Wu, Shengde; Wu, Chun

doi:10.1016/j.jpedsurg.2012.07.036

Cited by 96 publications

(80 citation statements)

References 26 publications

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“…Majority of children i.e 80.3%, were below 3 years of age, with mean age of 27.32 months. Similar observations were made in other studies [4][5][6]. Children in this age group are more vulnerable because of development of ability to stand and move around, tendency to use their mouth to explore the surroundings, lack molars, incomplete coordination between chewing and swallowing and lack of close supervision.…”

Section: Discussionsupporting

confidence: 86%

“…Although there was clear witness of aspiration of FB by an adult in 58 (81.7%) children and another 4 (5.6%) children had circumstantial evidence in our study, aspiration of FB was not witnessed in 9 (12.6%) children. Gang et al [6] had observed clear witnessed history in 73.8% cases while 26.2% did not have clear history of FB aspiration [6], although Naragund et al [7] noted definitive history only in 36.4% cases, while 65.6% cases were unwitnessed 7 . So even if unwitnessed, a diagnosis of FB should be kept in mind when dealing with respiratory diseases if other signs and symptoms of FB aspiration are present.…”

Section: Discussionmentioning

confidence: 97%

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Cinical Presentation of Foreign Body Aspiration in Children -An Observational Study

Chaudhary¹

2017

MOJCR

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Introduction: Aspiration of foreign body (FB) is a life threatening situation in children. A strong suspicion depending upon clinical presentation can lead to early diagnosis and treatment leading to decreased complication and mortality. This study was conducted to observe the clinical presentation of children undergoing rigid bronchoscopic removal of inhaled foreign bodies under general anaesthesia at a tertiary health care centre in north India.Method: A total of 72 bronchoscopic procedures were done in 71 children during the study period from August 2014 to july 2015. Preoperative demographic data, time interval between aspiration and admission, circumstances of aspiration, suspected type and site of FB, clinical presentation of children presented with suspected FB aspiration was evaluated. All the children underwent rigid bronchoscopy under general anaesthesia using controlled mode of ventilation.Result: Incidence of foreign body aspiration was more in male patients (70.4%). Most of the children(80.3%) were ≤ 3years of age. Most common FB was peanut, found in 42 (59.1%) children. FB was predominately located in right bronchus in 37 (52.1%) children. Playing and eating were the most common activities found in 34 (47.9%) and 32 (45.1%) of children respectively. Most common presenting symptom in our study was cough in 49 (68.1%) cases, followed by noisy breathing/ wheeze in 26 (36.1%) cases. Air entry was decreased in 53 (73.6%) cases and hyperinflation was the most common chest X-ray finding in 44 (61.1%) children.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 97%

Cinical Presentation of Foreign Body Aspiration in Children -An Observational Study

Chaudhary¹

2017

MOJCR

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“…Materials such as gelatinous snacks that completely obstruct the small cylindrical airways and some types of small toys are exceedingly dangerous (10). In contrast to the inorganic foreign bodies, such as toy parts, pen caps or pins, organic foreign bodies are more inducive to inflammatory reactions and symptoms of fever and pneumonia are observed more frequently (7). Some organic foreign materials may swell due to fluid absorption after aspiration and the partial blockage can become total in time.…”

Section: Clinical Presentation and Diagnosismentioning

confidence: 99%

“…If the patient is in a stable condition, it has been recommended that bronchoscopy be performed in day time operating hours with experienced anaesthesiologists and surgeons under optimal conditions (8,(11)(12)(13). Despite recent preference in some centers for using the fiber-optic bronchoscope, use of the rigid bronchoscope remains the gold standard (7,11,14,15). Although the fiber-optic bronchoscopy has the disadvantages of limited suction and instrumentation, and the lack of ventilatory capability and airway control, it has advantages in being less invasive, and in not requiring general anaesthesia.…”

Section: Managementmentioning

confidence: 99%

The anaesthetic consideration of tracheobronchial foreign body aspiration in children

Kendigelen

2016

J. Thorac. Dis.

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Cases of tracheobronchial foreign body aspiration are frequently encountered emergency cases of childhood; and, delays in its recognition and treatment do result in serious morbidity and mortality.Diagnosis mainly relies on taking history which should indicate what the foreign body is, when it has been aspirated and where it is located. Belated consultation can cause misdiagnosis with the mixing of the symptoms and data with those of other pathologies common to childhood and further delays in the correct diagnosis. Bronchoscopy is required for the differential diagnosis of suspected tracheobronchial foreign body aspiration in order to eliminate other common pediatric respiratory concerns. Given the shared use of the airways by the surgeon and the anaesthesiologist, bronchoscopy is a challenging procedure requiring experienced teams with an efficient method of intercommunication, and also well planning of the anaesthesia and bronchoscopy ahead of the procedures. Despite the recent popularisation of the fiberoptic brochoscopes , the rigid bronchoscopy remains to be used commonly and is regarded to provide the gold standard technique. There have been reports in the literature on the uses of inhalation and/or intravenous (IV) anaesthesia and spontaneous or controlled ventilation methods without any demonstration of the superiority of one technique over the other. The most suitable methods of anaesthesia and ventilation would be those that reduce the risks of complications, morbidity and mortality; and, preventive measures should be taken with priority against childhood cases of tracheobronchial foreign body aspiration.

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“…In our study, the most common FBs were beans. Gang, in his 2012 research, reported peanuts as the most common FBs to be aspirated [26]. The most common FBs in East Asian countries, such as China, were organic objects, such as nuts (fresh and dried) and peanuts, while in European countries, such as Italy and Kosovo, organic materials including dried nuts where the most common.…”

Section: Resultsmentioning

confidence: 99%

25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

Saki

Nikakhlagh

Heshmati

2014

Indian J Otolaryngol Head Neck Surg

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This study was conducted to review the abundance and diversity of radiopaque foreign bodies over a 25-year period. Overall records of 1,114 patients who underwent rigid bronchoscopy due to foreign body aspiration in the tertiary centres, Imam Khomeini and Apadana; over a 25-year period (1989-2014) were reviewed. History, clinical findings, plain radiography and bronchoscopic findings, foreign body (FB) aspiration (whether radiolucent or radiopaque), time from onset of symptoms until hospitalization, and delay time were all considered. The male/female ratio was 1.53. Most patients were aged 1-3 years (53.94 %). The most common location of foreign bodies was the right main bronchus (54.57 %). The most common type of radiopaque foreign body was meat, chicken and big fish bones (4.84 %) followed by metal objects (4.39 %). Coughing (70.82 %) and cyanosis (22.80 %) were the most common symptoms. The most common radiological findings were emphysema (32.31 %). Given that the radiological findings are highly specific as regards the detection of radiopaque FB, radiographic examination prior to bronchoscopy for FB localization and shortening the time of bronchoscopy in patients with a history of radiopaque FB aspiration can be helpful. Due to the high morbidity and mortality caused by prolong and repeated bronchoscopy, the use of newer techniques and equipment in shortening extraction time of the foreign bodies should be considered in future researches.

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Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children

Cited by 96 publications

References 26 publications

Cinical Presentation of Foreign Body Aspiration in Children -An Observational Study

Cinical Presentation of Foreign Body Aspiration in Children -An Observational Study

The anaesthetic consideration of tracheobronchial foreign body aspiration in children

25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

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