Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy: experience 1995-2006
ABSTRACT Tracheobronchial foreign body (TFB) removal in adult patients using the combined technique of flexible bronchoscopy (FBSC) through the endotracheal tube as well as using the simple FBSC has not often been described. This study reports our experience with FBSC for removal of TFBs and describes diagnosis, techniques of removal, and types of TFBs.
We retrospectively examined bronchoscopic records of adult patients performed between 1995 and 2006 and collection of foreign bodies in Clinical Department for Respiratory Diseases, University Hospital Split, Croatia.
TFBs were found in 86 (0.33%) out of 26,124 patients who were submitted to bronchoscopy. The majority of the patients (90%) had some risk factor for aspiration, among which stroke (30%) was the most frequent. Patients with different neurologic and neuromuscular diseases together accounted for 58% of all patients with TFB aspiration. Medical history was suggestive of foreign body aspiration in 38.4% of the patients, while chest X-ray was indicative in 7% of the patients. TFBs were most often found in the right bronchial tree (75.6%). The most common TFBs were animal and fish bones (39.5%). In 90.7% of the patients they were successfully removed under FBSC, whereas in 8.1% of the patients a TFB was extracted with flexible bronchoscope through endotracheal tube. Surgery was needed in only one case.
Although foreign bodies in the tracheobronchial tree are rare in adults, the clinician must be aware of their likelihood. Foreign body aspiration should be considered especially in the etiology of recurrent lung diseases and in the presence of risk factors for aspiration, in particular with different neurologic and neuromuscular diseases. They can be successfully and safely removed in the majority of patients under local anesthesia by using FBSC. In cases when repeated procedure is needed, endotracheal tube is recommended.
- SourceAvailable from: Marcelo Fouad Rabahi[Show abstract] [Hide abstract]
ABSTRACT: Objective: To analyze bronchoscopy as a diagnostic and therapeutic method in patients with tra-cheobronchial foreign body. Methods: We analyzed reports of flexible bronchoscopy with diag-nose of tracheobronchial foreign body performed from 2003 to 2013 in São Salvador Hospital, in Goiania, capital of Goiás. The analysis was based on: sex and age of the patients, airways and for-eign body characteristics, foreign body localization, success rate and rate of bleeding. We calcu-lated the frequencies after analyzing the data. Results: We analyzed 26 reports of the studied pe-riod and found that 57.7% of the patients were male with median age of 58.83 years old (+−13.79). The airways characteristics were normal in most of the cases. Sputum wasn't found in 57.69% of the cases. Foreign bodies were located in right bronchus in 88.46% of the cases, and the extraction of them was successful in 80.76% of the cases. The absence of bleeding was reported in 96.15% of the cases. Conclusions: Flexible bronchoscopy is a notably successful method in management of tracheobronchial foreign bodies. Airways characteristics aren't good indicatives of FB's presence, once they are normal in most of the times.International Journal of Clinical Medicine 06/2014; 5(5):704-710. DOI:10.4236/ijcm.2014.512096
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ABSTRACT: A fifty year old female presented with cough, breathlessness and chest pain of eighteen months duration. She presented as a case of a non-resolving consolidation. Video bronchoscopy revealed a bronchial foreign body. This case is being reported here, to underline the role of bronchoscopy in a case of a non resolving consolidation.08/2013; 7(8):1750-1752. DOI:10.7860/JCDR/2013/6116.3255
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ABSTRACT: ab b a Abstract To determine the incidence and the clinical, radiographic, and endoscopic characteristics of adult patients in our area diagnosed with tracheobronchial foreign bodies (FBs), we have performed a descriptive retrospective study analysing rigid and flexible bronchoscopies practised at our department between 1987 and 2008 in patients older than 14 years. Of the 9781 bronchoscopies performed, 32 involved cases of bronchoaspiration of FBs. The mean age of the patients was 43.81 years (S.D. 21.43); 65.6% were male and 34.4% were female. Acute or recurrent infection was the most frequent clinical presentation. Chest radiographs provided data for diagnosis in 68% of the cases. The most common FB aspirated were inorganic (pins and plastic devices 21.4%, respectively). In conclusion, we can state that in our area tracheobronchial aspiration of FBs by adults is not common. The clinical symptoms are highly variable and the FBs are usually lodged in the right bronchial tree. 2009 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.