Management of tracheo-bronchial foreign bodies at a tertiary care hospital in Eastern part of India

Abstract

Accidental Foreign body aspiration is common in children presenting to emergency outpatient department. Early diagnosis from clinical and radiological investigations is pivotal for successful removal of aspirated foreign body. We here report 35 cases of foreign body aspiration with respect to clinical features, type and location of foreign body, complications during bronchoscopy.To evaluate the clinical presentation, diagnosis & management of tracheo-bronchial foreign bodies in a tertiary care hospitalThis was a retrospective study of 35 cases of foreign body removal done between January2018to January2020. We included those cases that had history of aspiration, sudden onset of breathlessness or choking sensation in a healthy person, recurrent respiratory infections with clinical or radiological evidence, and suspicion of foreign body. Every case was documented with respect to age, sex, nature, site of foreign body lodgement, duration between inhalation or symptoms and admission in a hospital, clinical symptoms and signs, chest radiography findings, results and complications of bronchoscopy.The most common age group was between 1-6 years. Most of the patients attended hospital after 7 days of aspiration without any emergencies. History of aspiration and respiratory distress were the common presentation. Fever was present in those who presented late to the emergency department. About 25 cases (71.4%) had diminished or absent breath sounds followed by 12 cases (50%) of stridor, 15 cases (42.8%) diminished percussion notes. The common radiographic finding is obstructive emphysema and commonest site was right bronchus. Most of the foreign bodies were vegetative in nature.Early investigation with bronchoscopy is warranted when a strong clinical suspicion exists for foreign body aspiration, since bronchoscopy helps to resolve the symptoms quickly and prevent further complications