Management of Tracheobronchial Foreign Bodies in Adults and Children: 117 Cases
Journal Title: Journal of Cardiovascular Medicine and Surgery - Year 2019, Vol 5, Issue 1
Abstract
Objective:Tracheobronchial foreign body is commonly seen in children compared to adults. Accidental aspiration is the commonest cause .If not treated by timely intervention, leads to death and severe respiratory complications. Duration of presentation varies with size of the foreign body, age of the patient and symptoms. This study is conducted to know the nature of foreign body, symptoms, duration and age at presentation, diagnosis, complication and mode of removal of foreign body. Patients and methods: 117 patients between 6 months to 70 yrs of age with Tracheobronchial aspiration of foreign body were evaluated and treated in tertiary care referral hospital for respiratory and chest diseases over a period of 17 years. All patients were evaluated with Chest X-ray, bronchoscopy and relevant investigations. Both flexible and rigid bronchoscope was used for diagnosis. Rigid bronchoscope is used in all cases for removal of foreign body. Results: Out of 117 patients, 87 males (74%) out numbered 30 females (27%). More commonly seen in children less than 5 yrs of age. Half of the patients (50%) presented within 24 hours of ingestion. Only a few patients presented within 2 hours (5%) and some presented more than a year (7%) after the ingestion. Major symptoms were cough (39%), dyspnoea (24%) and wheezing (13%). Chest X-Ray showed visible foreign body in 30% and features of consolidation, collapse, hyperinflation in 53% of patients and normal chest radiograph in 17% patients. Organic Food items mainly various seeds, were the commonly ingested Tracheobronchial foreign body(TBFB) (47%) followed by plastic (30%) toy items and metallic items (21%). More than half of ingested TBFB were removed from right side (56%), more commonly from intermediate bronchus. In 111 patients (95%) bronchoscopic removal was successful and 6 patients (4%) required surgical intervention who presented late with complications. Conclusion: Accidental aspiration is the commonest cause of TBFB in children as well as adults. High index of suspicion is required in all cases and subjected to diagnostic bronchoscopy even though the radiological signs are negative for foreign bodies. Early diagnosis and intervention are at most priority to avoid further complications. In paediatric patients with recurrent, non-resolving lung infections, it should be evaluated for TBFB. Rigid bronchoscopy is an essential prerequisite in majority cases of foreign body removal, complimented by flexible bronchoscopy. Only a few patients required surgery, who presented with complications who were mis-diagnosed with fewer symptoms during initial period due to small size of TBFB.
Authors and Affiliations
Shivakumaraswamy Siddalingaiah Tumkur
Keywords
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- EP ID EP655391
- DOI 10.21088/jcms.2454.7123.5119.6
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