Body In Tracheobronchial Tree Research Articles

Role of Virtual Bronchoscopy in Evaluation of Suspected Foreign Body in Children's Tracheobronchial Tree

Abstract Introduction The presence of foreign bodies in the airways remain a diagnostic challenge to healthcare professionals. They can become life threatening emergencies that require immediate intervention or go unnoticed for weeks and even months. Prevention is best but early recognition remains a critical factor in treatment of foreign body inhalation in children. Objective To study the diagnostic advantages of virtual over rigid bronchoscopy in the evaluation of children with suspected foreign body in the tracheobronchial tree and plan for early management. Methods A crossectional study conducted at a tertiary care hospital & medical college in India. A total 24 patients (0-12-years-old) who presented with complaints of sudden onset of coughing, choking, and breathing difficulty were included during the 2-year duration, from January 2018 to December 2019. All patients underwent virtual and rigid bronchoscopy. Results In 8 patients, foreign bodies detected by virtual bronchoscopy were confirmed by rigid bronchoscopy. There was one case in which virtual bronchoscopy showed no foreign body, but rigid bronchoscopy detected it. In 15 cases virtual and rigid bronchoscopy did not show foreign bodies. The sensitivity, specificity, positive and negative predictive value of virtual bronchoscopy were 88.88, 100, 100, and 93.75%, respectively. Conclusions Virtual bronchoscopy is less invasive and does not require general anesthesia but cost and availability are limitations. It can be used as method of investigation in children with suspected foreign body aspiration.

Diagnostic and therapeutic role of bronchoscopy in suspected cases of foreign bodies in tracheobronchial tree in pediatric age group

<p class="abstract"><strong>Background: </strong>Aim and objectives were to review the importance and benefits of bronchoscopy in suspected foreign body aspiration in tracheobronchial tree, prompt diagnosis and early management, and correlation between clinical and bronchoscopic findings.</p><p class="abstract"><strong>Methods: </strong>A retrospective study was conducted. Total 50 pediatric patients were enrolled in our study who were giving strong history of foreign body aspiration with sudden respiratory symptoms. Chest X-ray PA view was performed in all the patients. All the bronchoscopy done under general anesthesia.</p><p class="abstract"><strong>Results: </strong>In our study, children between 6 months to 3 years of age are the commonest victims, males are more affected than females. Classic triad of unilateral wheeze, coughing, and ipsilateral reduced air entry-is observed in less than 50% of cases.</p><p class="abstract"><strong>Conclusions: </strong>Bronchoscopy is essential in all cases of bronchial foreign body known or suspected and rigid bronchoscopy has proven over time to be safest and most efficacious to therapy. Although X-ray examination is essential for diagnosis and management, CT thorax with virtual bronchoscopy is advisable before bronchoscopy procedure in suspected cases (if general condition permits), it gives better idea about exact location, nature and type of foreign body. </p>

Komplikasi Kronik Benda Asing Pada Percabangan Bronkus

CHRONIC COMPLICATION OF FOREIGN BODY IN TRACHEOBRONCHIAL TREE : A CASE REPORT
 Foreign body aspiration in tracheobronchial could be life threatening particularly if the object large enought to cause nearly complete obstruction. In the other hand small object could pass beyond carina and cause less severe sign and complication manifest. Chronic symptoms with recurrent infection that lead to brochiectasis may occur in delayed of extraction. We presented a case of nail aspiration by a 17 years old male patients who presented with hemoptysis. The patient had history of nail aspiration six months ago and had no symptom until the last one week . First attempt of evacuating used rigid bronchoscopy under general anesthesia had failed. Fiber optic bronchoscopy (FOB) found the nail at the orificium of right lower lobe and chest computed tomography stated the occurancy of bronchiectasis at distal of nail. The extraction was performed by FOB with local anesthesia succeeded to remove the nail to the laring that induced cough and nail threw out. There were no major complication and further symptoms after the extraction. Eventhough aspiration small object cause no symptom, it could lead to chronic complication such as bronchiectasis. FOB for removing the object is supposed to perform carefully because the object could fall on another part of brochial tree when it was pulled out.
 Keywords
 Foreign Body, Bronchial tree, complication, flexible bronchoscopy

OUR EXPERIENCE IN THE TREATMENT OF CHILDREN WITH FOREIGN BODIES IN THE LOWER RESPIRATORY TRACT

Urrently, the problem of foreign bodies in the airways of children continues to be relevant. Aim - to assess the effectiveness of diagnostics and treatment of children with foreign bodies in tracheobronchial tree. Materials and methods. In the Department of otorhinolaryngology, the SBHI of MAMRRCI n.a. M.F. Vladimirskiy, we performed an integrated research of 189 children of different age, who had aspirated foreign bodies in the airways. We studied anamnestic, clinical, roentgenological and endoscopic criteria for the diagnosis of this pathology; we also studied the frequency of clinical complications caused by aspiration. Results. Follow-up observation of these children shows a significant frequency of remaining changes in the lungs after removal of foreign bodies. Discussion. In our opinion, for correct diagnosis and provision of qualified care to sick children it is necessary to raise awareness of parents and primary care physicians about the dangers of this pathology. If there is a reason to suspect a foreign body in the airways, consultation in a specialized institution is vitally important. The only correct method of treating children with foreign body in the airways, even at the slightest suspicion, is timely performed tracheobronchoscopy.

Broken Metallic Tracheostomy Tube Migrating into the Tracheobronchial Tree

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.

Removal Of Tracheobronchial Foreign Bodies Using Flexible Bronchoscopy - A Retrospective Study.

Introduction: Foreign body in tracheobronchial tree is a potentially life threatening situation and it requires emergency removal. Materials & Methods: We conducted a retrospective, descriptive study of the patients in which we performed flexible bronchoscopy with suspicion of tracheobronchial foreign bodies from 1 st October, 2012 to 30 th September, 2014 (2 Years). Results: Out of 56 suspected cases, tracheobronchial foreign bodies were found in 42 occasions (75%). Among these 42 cases, most were male (69%) and common age group was below 5 years (53%). Most of the patients presented with choking (40%) while few were asymptomatic (12%). Most common complication due to delayed removal of foreign body was pneumonia. X-ray was suggestive of foreign body only in 6 cases (14%). Most common location of foreign body was in right bronchial tree (52%). Seeds were most common foreign bodies (38%). Conclusion: Diagnosis of tracheobronchial foreign bodies is challenging as few patients can be asymptomatic and plain X-ray fails to detect foreign bodies in majority of cases. Considering the risks associated with tracheobroncheal foreign bodies, it is advisable to perform diagnostic bronchoscopy in all suspected cases.

Usefulness of virtual bronchoscopy in evaluation of suspected foreign body in tracheobronchial tree

<p class="abstract"><strong>Background:</strong> Airway foreign bodies remain a diagnostic challenge to health care professionals. They can become life threatening emergencies that require immediate intervention or can go unnoticed for weeks and even months. Every effort should be made to avoid a delay in diagnosis because this may lead to a notable increase in complication rates. The objective of this study is to investigate the usefulness of virtual bronchoscopy in evaluation of suspected foreign body aspiration in tracheobronchial tree.</p><p class="abstract"><strong>Methods: </strong>This retrospective & prospective study of 100 patients is conducted in the department of otorhinolaryngology & Head & Neck Surgery, Saraswathi Institute of Medical sciences, Hapur, Uttar Pradesh, India; from August 2011 to August 2015. Cases referred from department of paediatrics, with history of sudden breathlessness, sudden onset of cough with or without cyanosis & with or without pyrexia. </p><p class="abstract"><strong>Results:</strong> In our studies highest incidence of foreign bodies i.e. 61% were seen in the children between the age of 1-5 yrs 73% cases were male children while 27% were female children. Incidence of FB was quite higher in low socio economic status group (63%) as compared to middle class (34%) In our studies maximum no of cases i.e. 31% were betel nut followed by custard apple 22%. Others include gram seed (8%), tamarind seed (6%), coconut (5%) and ground nut (10%). In our studies, majority of FB in air passage were in right main bronchus 57% followed by upper air passage (22%) & 21% in left main bronchus.</p><p><strong>Conclusions:</strong> FB aspiration is an anaesthetic emergency and senior help should be sought early. Techniques should be tailored to the clinical context but spontaneous respiration should be maintained wherever possible. VB is proving to be a very helpful investigation modality in patients of a compromised airway. VB works well in planning the further management protocol not only in conjunction with other modalities but also on its own It is accurate but its accuracy is not 100% because of false positive & false negative results. VB will never replace actual bronchoscopy (gold standard) but it can assist & complement it. </p>

RIGID BRONCHOSCOPY

Objectives: To evaluate foreign bodies in tracheobronchial tree and effectiveness of the therapeutic use of rigid bronchoscopy in a tertiary care setting. Study Design: Descriptive study. Place and duration of study. This study was carried out at Department of ENT and Head and Neck Surgery, Combined Military Hospital, Rawalpindi from June 2006 to June 2010. Patients and methods: This descriptive study was designed to evaluate the foreign bodies in tracheobronchial tree & effectiveness of the use of rigid bronchoscopy in a tertiary care setting. Sixty two patients underwent initial evaluation by ENT consultants and senior registrars followed by management with rigid bronchoscopy. Results: The most commonly affected age group was under 4 years. Male to female ratio was 3:1. Right main bronchus was affected in 51.61% cases. Most of the foreign bodies removed were organic in nature in 90.32% cases. The success rate for removal with rigid bronchoscopy was achieved in 98.39% cases, with fewer complications and no mortality Conclusions: It may be concluded from this study that early diagnosis & management is essential to prevent morbidity & mortality associated with foreign bodies. Rigid bronchoscopy is the most effective procedure for the removal of foreign bodies in tracheobronchial tree.

Foreign body in tracheobronchial tree.

Foreign body inhalation into the tracheobronchial tree can prove to be a life threatening unless timely intervened and appropriate steps are being taken towards its management [1]. A review of 32 cases was done at MP Shah Medical College Jamnagar over a period of 2 years. Children were most susceptible to aspiration of foreign bodies. All the cases were selected on the basis of detailed clinical history, clinical features, and radiological findings. The cases which had a strong index of suspicion without any positive clinical history were also subjected to rigid bronchoscopy under general anesthesia. Maximum number of cases was in the age group of 1 to 3 years (62.5%). The minimum age group ranging from 6 months to maximum 8 years. The time of presentation of the patients varied from within 24 hours to upto 6 months. Only four patients presented within 24 hours. The maximum presenting period was within 1 week. Organic foreign bodies were most common presentation (groundnut). Other foreign bodies were grains, seeds, ball pen cap, stones and slate pencil. Definite history of inhalation was available only in 19 cases with symptoms of choking, breathlessness, cough and recurrent upper respiratory tract infection. Right main bronchus was found to be most common site of impaction (52%) followed by left main bronchus (32%) and tracheal foreign body (16%).

CT virtual bronchoscopy: New non invasive tool in pediatric patients with foreign body aspiration

A 2-year-old girl presented with recurrent cough, wheese and breathing difficulty. Her imaging (CT and virtual bronchoscopy) revealed a foreign body in tracheobronchial tree, that was removed by rigid bronchoscopy.

Foreign body in tracheobronchial tree.

Inhalation of foreign body into the tracheobronchial tree is a medical emergency sometimes resulting into sudden death. The current mortality rate due to foreign body inhalation ranges from 0% to 1.8%. Children with or without positive history of aspiration were examined and diagnosis was made on the basis of history, clinical findings, radiological evaluation and strong index of suspicion. A review of 30 cases of suspected foreign body aspiration revealed, children between 6 months were found to be very vulnerable to aspiration. Majority of children were boys. 80% of the patients had positive history of inhalation. Only 50% of the patients presented immediately i.e. within 24 hours after aspiration. Common symptoms were cough and respiratory distress. Decreased air entry was the significant clinical sign (50%). Obstructive emphysema and mediastinal shift were found in the majority of cases (50%). Rigid bronchoscopy under general anaesthesia and patient ventilating using a jet ventilator is a very safe and effective technique.

A comparison of halothane and sevoflurane for bronchoscopic removal of foreign bodies in children.

The present study was designed to compare induction and recovery characteristics of sevoflurane and halothane for rigid bronchoscopy for removal of foreign bodies in tracheobronchial tree in children. Forty four children (age 1-4 years) were allocated randomly to two groups to receive either halothane (group H; n=22) or sevoflurane (group S; n=22) in oxygen. A graded inhalation technique was used with maximum inspiratory concentration of 5% for halothane and 8% for sevoflurane. Time for loss of consciousness and induction time in group H and group S were 2.3+/-0.4 min vs 2.2+/-0.4 min (p>0.05) and 4.6+/-0.7 min vs 4.9+/-0.6 min (p>0.05) respectively. Intubation conditions with rigid bronchoscope were similar in both groups. Fewer children in group H had vocal cord movements as compared to group S on laryngoscopy (3 vs 8, p>0.05). Six children in group H and two children in group S had disturbances of cardiac rhythm (p>0.05). Emergence time was significantly shorter in group S as compared to group H (group H - 29.6+/-10.7 min vs group S- 12.3+/-7.6 min, p<0.05). Modified Aldrete's score of 8 was achieved significantly faster in group S as compared to group H (group H - 33.8+/-9.3 min vs group S- 17.3+/-6.8 min, p<0.05). Adverse events during induction and recovery were comparable between the two groups except for significantly high incidence of excitement in group S. In conclusion, halothane is as suitable as sevoflurane for children undergoing rigid bronchoscopy for airway foreign body retrieval, but sevoflurane has a quicker recovery.

Forgotten foreign bodies in bronchial tree in adult (A report of two cases and review of literature)

Forgotten foreign bodies in bronchial tree in adult (A report of two cases and review of literature)

An autogenous foreign body in tracheobronchial tree

Foreign body in the trachea is not uncommon but foreign body of autogeneous origin is rare with stray dog bite.

A Retrospective Review of Foreign Body Inhalation in the Asir Region

A Retrospective Review of Foreign Body Inhalation in the Asir Region

Tracheostomy tube fracture an unusual fatal complication of tracheostomy

Fractured tracheostomy tube presenting as a foreign body in tracheo-bronchial tree is rare complication of tracheostomy. Only few cases are available in the literature so far and fatality has not been reported in these cases. The present case remained almost asymptomatic for nearly a month and then suddenly died of asphyxia.

Unusual foreign body in tracheo-bronchial tree

Uptill now many grass foreign bodies are reported, but full stalk of Bazari (Pennisetum typhoides) as foreign body in tracheo-bronchial tree has not been reported in the literature. This inspired us to report the case.

Kircha (areca nut) as foreign body in tracheobronchial tree

A series of 21 cases of areca-nut as foreign body in tracheobronchial tree is presented. The taxonomy of the nut has also been described.

A unique foreign body in bronchus: surgical challenge

Exogenous foreign bodies in tracheo bronchial tree are not uncommon, particularly in children. The gold standard principal of foreign body management is bronchoscopic removal and this procedure becomes difficult and challenging in cases of large and smooth foreign body as occur in our case. The present article reports a case of unique and large foreign body i.e. intact glass bulb in right main bronchus. Key words: Foreign body; Bronchus.DOI: http://dx.doi.org/10.3329/bjo.v17i2.8854 BJO 2011; 17(2): 132-134

BEAD; A DIFFICULT TRACHEOBRONCHIAL FOREIGN BODY TO RETRIEVE; BRONCHOSCOPIST PERSPECTIVE.

To know the efficacy of different instruments in retrieval of bead from tracheobronchial tree.BACKGROUND: Bead is uncommon object in western world and therefore rarely recorded as aforeign body in tracheobronchial tree. No specific instrument being named for its retrieval. Our studyfocuses on different instruments we used and its outcome.MATERIAL AND METHODS: This was retrospective study of foreign body bead impaction intracheobronchial tree. All patients subjected to bronchoscopy with definite clinical findings of beadimpaction on radiology or bronchoscopic examination were recorded, with different instruments used. Inall cases Karlstorz rigid bronchoscopes of size 3.0 to 5.0 with fiber optic light used. Long bronchoscopicscrew forceps, malleable forceps. Large nasal killian forceps was used after tracheostomy in some cases.Study period: 1st January 2008 to December 2012.Site: ENT A unit Hayatabad Medical Complex Peshawar.RESULTS: In our study of 3 years 32 cases were recorded with bead impaction in tracheobronchealtree. 21(65.62%) were male and 11 (34.37%) female. Age ranges below 1 year was 1 (3%) case,between lyear and 2 years 6 (18.75%) cases, 2 years to 3 years 21(65.62%) and 3 years and above 4(12.5%) cases recorded. 21(65.62%) beads were retrieved with malleable forceps, 8 (25%) with longscrew forceps, 1 (3%) after tracheostomy with long killan nasal forceps and 2 (6.25%) impacted beadswere referred to cardiothoracic department for thoracotomy. 3 (9.37%) beads were impacted in maintrachea, 19 (59.53%) in right main bronchus and 10 (31.25%) in left main bronchus.CONCLUSION: Bead is one of the difficult foreign body tracheobroncheal tree and needs specialinstruments for its removal.KEY WORDS: Beeds, Boronchoscopy,