Erişkinlerde Trakeobronşiyal Yabancı Cisimler

Abstract

Yabanci cisim aspirasyonu, acil girisim gerektiren ve yasami tehdit edici bir durum olusturabilir. Ulkemizde, ozellikle eriskinlerde yabanci cisim aspirasyonu oldukca siktir. Bu calismada amac, eriskinlerdeki trakeobronsiyal yabanci cisim aspirasyonlarinin etiyolojisi, klinigi, bronkoskopik tedavinin onemini belirterek tedavi sonuclarini degerlendirmektir. Ocak 1998 - Aralik 2003 arasinda Ondokuz Mayis Universitesi Tip Fakultesi Gogus Cerrahisi Anabilim Dali'nda trakeobronsiyal yabanci cisim aspirasyonu tanisiyla bronkoskopi uygulanan 53 hasta retrospektif olarak degerlendirildi. Tani hikaye, fizik muayene, radyolojik bulgular ve bronkoskopi ile konuldu. Hastalarin yas araligi 14-58 olup yas ortalamasi 24±1.6 yil idi. Hastalarin 44'u (%83) kadin, 9'u (%17) erkekti. Basvuru aninda 18 (%34) hasta semptomatikti ve en sik semptom oksuruktu (%17). En sik rastlanan radyografik anormallik radyo-opak yabanci cisim gorulmesi idi (%81). Bronkoskopi uygulanan hastalarin 50'sinde (%94) yabanci cisim tespit edildi, uc hastada yabanci cisime rastlanmadi. Uc hastaya rijid + fleksibl bronkoskopi uygulandi ve yabanci cisim cikarilmadi. Bu olgulara (%5.6) torakotomi + pnomotomi uygulandi. Yabanci cisimlerin; 24'u (%48) sag bronsiyal sistemde, 18'i (%36) sol bronsiyal sistemde ve 8'i (%16) trakeada tespit edildi. Yabanci cisimlerin buyuk cogunlugunun (%80) turban ignesi oldugu goruldu. Trakeobronsiyal yabanci cisim aspirasyonunda erken tani ve tedavi onemlidir. Trakeobronsiyal yabanci cisimler bronkoskopi ile basariyla cikarilabilir. Bolgelere ve ulkelere gore aspire edilen yabanci cisimler cesitlilik gostermektedir. Tracheobronchial Foreign Bodies in Adults Foreign body aspiration can be a life-threatening emergency requiring immediate intervention. In our country and especially in adults, the prevalence of foreign bodies aspiration is high. In this study, the aim is to evaluate results of the treatment, as well as pointing the importance of bronchoscopic treatment, and etyology and clinics of tracheobronchial foreign bodies in adults. Between January 1998 and December 2003, at Ondokuz Mayis University Medical School, Department of Thoracic Surgery, 53 patients were examined with a suspicion of tracheobronchial foreign body aspirations, retrospectively. The diagnosis was made on history, physical examination, radiological methods and bronchoscopy. The age interval of the patients was 14 to 58 and the mean age was 24±1.6 years. Nine (17%) of them were male and 44 (83%) of them were female. Eighteen (34%) patients were symptomatic on admission and the most frequent symptom was cough (17%). The most common radiographic abnormality found in 81% of the cases was a radiopaque foreign body. All 53 patients had bronchoscopic evaluation, and at 50 (94%) of them foreign bodies were identified. Only in three cases a foreign body was not found during the bronchoscopy. In 3 (5.6%) cases, in which rigid + flexible bronchoscopy were unsuccessful, thoracotomy + pneumotomy was applied. Foreign bodies were localized in the right bronchial tree in 24 (48%) cases, in the left bronchial tree in 18 (36%) cases and in the trachea in 8 (16%) cases. The majority of the foreign bodies were turban pins, in 40 (80%) cases. Early diagnosis and treatment is important in tracheobronchial foreign body aspiration. Tracheobronchial foreign bodies can be successfully removed with bronchoscopy. Aspired foreign bodies vary from region to region and country to country.