Abstract
Distally impacted chronic tracheobronchial sharp foreign bodies in children are a management challenge that presents with clinical subtlety and extreme variability. The use of image guided techniques, imaginative instrumentation, tracheotomy, thoracotomy, and even extracorporeal membrane oxygneation have been reported. Endoscopy is made difficult by the distal location, inflammatory reaction with granulation tissue formation, and bleeding obscuring the foreign body. Our aim is to describe our experience with two children who had removal of aspirated impacted sharp metallic foreign bodies from the distal airway using rigid bronchoscopy, preceded by maximal medical therapy.
Highlights
Aspirated foreign bodies most commonly occur in children younger than 3 years of age, and may relate to immature dentition and a poorly coordinated swallowing mechanism [1, 2]
Tracheobronchial foreign body (TFB) aspiration is an important differential consideration in a child presenting with hemoptysis
The majority of patients with TFB aspiration are under 3 years of age, it may occur in older children and adolescents
Summary
Aspirated foreign bodies most commonly occur in children younger than 3 years of age, and may relate to immature dentition and a poorly coordinated swallowing mechanism [1, 2]. Case 2 13-year-old boy, previously healthy, presented with a 4month history of hemoptysis, shortness of breath, and right chest pain His chest x-ray showed a vertically oriented 1.4 cm metallic foreign body in the right lower lobe bronchus and a region of focal airspace consolidation at the posterior basal segment of the right lower lobe suggestive of pneumonia (Fig. 2a and b). He was taken to the operating room for a flexible fiberoptic bronchoscopy by the Pediatric Pulmonary service. The metallic foreign body was identified in the right lower lobe bronchus was removed with telescopic optical forceps (Fig. 2c)
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