Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy: Experience 1995-2006

Clinical Department for Respiratory Diseases, University Hospital Split, Spinciceva 1, 21 000, Split, Croatia.
Surgical Endoscopy (Impact Factor: 3.26). 11/2008; 23(6):1360-4. DOI: 10.1007/s00464-008-0181-9
Source: PubMed


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.

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    • "This is possible even when the bronchi are distorted, displaced or with stenosis. In addition, material can be obtained from bronchi under direct vision by using brushes or biopsy curettes [6]-[9]. The objective of our study was to analyze flexible bronchoscopy as diagnostic and therapeutic method in patients with TFB. "
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    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.
    Full-text · Article · Jun 2014 · International Journal of Clinical Medicine
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    • "On the other hand, TFB aspiration is rare in adults, comprising roughly 0.33% of bronchoscopy cases (7). Ninety percent of patients have a risk factor for aspiration, with stroke being the most common of these, at 30%. "
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    ABSTRACT: Introduction: Tracheobronchial foreign body may often be treated as asthma, chronic bronchitis or etc. especially in patients with no memories of aspiration episodes. Case Presentation: A 74-year-old woman, suffering from persistent cough, was temporarily misdiagnosed with allergic bronchopulmonary aspergillosis and treated for six months. During this period, computed tomography (CT) findings changed from thickened bronchial walls and a “tree-in-bud” pattern to clubbing bronchiectasis and atelectasis, and no significant bacteria was detected. Finally, a vegetable core was subsequently extracted via flexible bronchofiberscopy. Although the patient's symptoms improved dramatically, the bronchopulmonary lesion remained practically. Conclusions: We assume that chronologic CT findings of the bronchopulmonary damage by aspiration of a vegetable core, without significant detection of bacteria during the course, will be quite valuable for clinicians.
    Full-text · Article · May 2014
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    • "However, fiberoptic / video bronchoscopes have been utilized on occasions to remove them. In fact, Mise et al., in their study, have shown that tracheobronchial foreign bodies can be successfully and safely removed in a majority of the patients under local anaesthesia by using flexible bronchoscopes [4]. "
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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.
    Full-text · Article · Aug 2013
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