Bronchial Foreign Body Research Articles

Bronchial foreign body presenting as pneumothorax and pneumomediastinum in a young child.

Pneumomediastinum (PM) and subcutaneous emphysema (SCE) following foreign body aspiration are very rare. Pneumomediastinum (PM) occurs due to alveolar rupture, whereas subcutaneous emphysema occurs if air leak persists. It is benign in nature, but in some cases, it might be fatal. Therefore, proper assessment and management are required to limit the life-threatening complications and FB should always be suspected whenever spontaneous PM and SCE is seen. PM and SCE are very rare presentations of foreign body aspiration in children of age less than 3 years and in such circumstances, the possibility of foreign body should be considered. There is also a rare possibility of spontaneous expectoration of a foreign body dislodged in the trachea.

Case Report: Aspirated Airway Foreign Body Mimicking Endobronchial Mass: A Diagnostic Challenge

Abstract Introduction/Objective Despite advancements in imaging modalities, identifying retained foreign bodies within the lung remains arduous. Detecting small foreign bodies is crucial as they can serve as a focal point for subsequent infections. Initial assessments may mimic malignancy. Herein, we present a case of a retained foreign body masquerading as an endobronchial mass, accompanied by unilateral pleural effusion and persistent hypoxia. Subsequent bronchoscopy showed a pearly white endobronchial mass partially obstructing the segmental bronchus at the posterior basal segment of the right lower lobe of lung with accompanying right pleural effusion and atelectasis. Methods/Case Report This is a 58-year-old male with history of hypertension, deep vein thrombosis, transient ischemic attack, and a recent motor vehicle accident with blunt chest trauma. He had a thoracic spinal cord transection with grade III blunt thoracic aortic injury, developed anasarca, hypoxia, right pleural fluid requiring multiple thoracentesis, and right sided hemothorax requiring massive transfusion protocol. Subsequent evaluations, including bronchoscopic transbronchial forceps biopsies and bronchial wash and pleural fluid cytologic examinations showed no malignant cells. Repeat bronchoscopy was concerning for enlarging mass and obstruction. Bronchoscopy almost 2 months after MVA revealed an endobronchial foreign body (tooth) lodged in the left lower lobe of lung posterior segment. Results (if a Case Study enter NA) N/A Conclusion While aspiration of foreign bodies into the tracheobronchial tree is not uncommon especially in children, foreign bodies, particularly teeth, are rare in adults. Bronchial foreign body aspiration may occur in trauma, with diagnosis typically relying on history and physical examination. Detection remains challenging despite imaging advancements, with implications including infection nidus formation. In our case, delayed diagnosis highlights the importance of considering unusual etiologies in persistent pulmonary pathology. Retrospective imaging analysis and CT findings suggested a foreign body, emphasizing the utility of imaging in suspected cases. Prompt surgical intervention is crucial to prevent complications such as recurrent infections.

A case of bronchoscopic treatment for endobronchial chondroma

Endobronchial chondroma is a rare benign bronchial tumor that originates from bronchial cartilage. As the disease progresses, it can obstruct the airway and cause clinical symptoms such as fever and cough. It is difficult to detect Endobronchial chondroma on a Chest X-ray, but chest CT can provide a more accurate diagnosis. Bronchoscopy is an effective means of diagnosing and treating this disease, and the diagnosis of the disease still depends on the pathological results of the biopsy. Currently, most cases of Endobronchial chondroma are treated by bronchoscopic resection or by surgery. Treatment should be based on the size, type and location of the tumor. As long as the diagnosis of Endobronchial chondroma is confirmed, it should be removed as soon as possible to avoid obstructive pneumonia, atelectasis or irreversible damage to lung tissue caused by tumor compression of the bronchi. This article reported a case of Endobronchial chondroma in a 19-year-old man whose main clinical manifestations were fever, cough and chest pain, with no apparent improvement after antibiotic treatment. Chest CT showed consolidation and atelectasis of the left upper lobe, and bronchial foreign body was considered by bronchoscopy in another hospital. However, the patient did not improve significantly after the foreign body was removed. After admission, the patient was considered to have left pulmonary obstructive pneumonia due to bronchial foreign body. A white tough foreign body was seen under bronchoscopy, which was too seriously adhered with the bronchus to be removed as a whole. After two bronchoscopic interventional treatments, the foreign body was successfully removed, and the bronchial lumen blocked by the foreign body was restored to patency. Pathology confirmed the diagnosis of endobronchial chondroma. The patient's symptoms improved and he was subsequently discharged. To date, the patient's symptoms of fever, cough, or chest pain have never recurred, and there is no obvious abnormality on repeat chest CT. This case provides an empirical reference for the diagnosis and treatment of endobronchial chondroma.

Pulmonary destruction due to retained bronchial foreign body in a 13-year-old boy.

Pulmonary destruction due to retained bronchial foreign body in a 13-year-old boy.

Clinical characteristics and removal approaches of tracheal and bronchial foreign bodies in elders

The symptoms of tracheobronchial foreign body in the elderly are not typical, so they are often missed or misdiagnosed. This study aims to depict the clinical characteristics of tracheobronchial foreign body inhalation in the elderly. We retrospectively analysed the clinical data of elder patients (age ≥ 65 years) diagnosed with tracheal and bronchial foreign bodies. The data included age, sex, clinical symptoms, type and location of foreign bodies, prehospital duration, Chest CT, bronchoscopic findings, and frequencies and tools for removing these elderly patients' tracheal and bronchial foreign bodies. All patients were followed up for a half year. Fifty-nine cases were included, of which only 32.2% had a definite aspiration history. Disease duration > 30 days accounted for 27.1% of the patients. 27.1% of the patients had a history of stroke, and 23.8% had Alzheimer's Disease. Regarding clinical symptoms, patients mainly experience cough and expectoration. The most common CT findings were abnormal density shadow (37.3%) and pulmonary infiltration (22.0%). Under bronchoscopy, purulent secretions were observed in 52.5% of patients, and granulation tissue hyperplasia was observed in 45.8%. Food (55.9%) was the most common foreign object, including seafood shells (5.1%), bones (20.3%), dentures (18.6%), and tablets (20.3%). The success rate of foreign body removal under a bronchoscope was 96.7%, 28.8% of the foreign bodies were on the left and 69.5% on the right. 5.1% of the elderly patients required rigid bronchoscopy, and 6.8% required two bronchoscopies. In elderly cohorts, tracheal foreign bodies are obscured by nonspecific clinical presentations and a paucity of aspiration history, challenging timely diagnosis. Predominantly constituted by food particles, with a notable predilection for the left bronchial tree, these cases demand skilled bronchoscopic management, occasionally requiring sophisticated approaches for successful extraction.

Changes in Cellular Morphology in Bronchoalveolar Lavage Fluid of Children with Mycoplasma Pneumoniae Pneumonia

Objective To study changes of cell morphology in BALF in children with Mycoplasma pneumoniae pneumonia (MPP). Methods From December 2021 to May 2022, a group of 32 children diagnosed with Acute MPP and admitted for treatment in the Pediatrics Department and PICU of the First Affiliated Hospital of Xinxiang Medical University were selected for our study. These patients underwent bronchoalveolar lavage as part of their clinical assessment. For comparison, we included a control group comprising 10 children who were not infected but had bronchial foreign bodies. We investigated the cellular composition in the bronchoalveolar lavage fluid (BALF) using Wright-Giemsa staining and microscopic evaluation, aiming to understand the relationship between shifts in cell proportions and extra-pulmonary symptoms associated with MPP. Results In this study, a total of 42 cases were enrolled, with 32 cases in the study group and 10 cases in the control group. There were no statistically significant differences in gender, age, height, weight, and BMI between the two groups (p > 0.05). The study group exhibited significantly higher levels of neutrophil percentage (GRA%), CRP, D-dimer, and LDH in blood routine tests compared to the control group (p < 0.05). Furthermore, the proportions of neutrophils (%) and macrophages (%) in BALF were significantly higher in the study group compared to the control group (p< 0.05), while the proportion of lymphocytes (%) in BALF showed no statistically significant difference between the two groups (p> 0.05). Conclusion In the acute phase of MPP in children, BALF is predominantly composed of neutrophils. A lower proportion of lymphocytes in BALF is associated with a higher incidence of extra-pulmonary manifestations and longer hospitalization duration.

Occult foreign body in bronchus masquerading clinically as malignant hyperthermia.

Occult foreign body in bronchus masquerading clinically as malignant hyperthermia.

IL-27 Levels in Bronchoalveolar Lavage Fluid in Children with Post-infectious Bronchiolitis Obliterans.

Pulmonary neutrophils may play a crucial role in the development of bronchiolitis obliterans (BO) following measles virus infection. IL-27 could potentially have a negative regulatory effect on the release of reactive oxygen species and cytotoxic granules in neutrophils. To investigate the levels of IL-27 in the bronchoalveolar lavage fluid (BALF) of children with post-infectious bronchiolitis obliterans (PIBO) and analyze the relationship between IL-27 levels and neutrophil proportions. A total of 24 children with PIBO were recruited for the experimental group, while 23 children with bronchial foreign bodies were included in the control group. Bronchoscopic alveolar lavage was performed in both groups. The levels of IL-27 in BALF were measured using enzyme-linked immunosorbent assay (ELISA). The proportions of neutrophils in BALF were determined by smear staining. The relationship between the levels of IL-27 in BALF and the neutrophil proportions was analyzed by the Pearson test. The levels of IL-27 in BALF were significantly lower in children with PIBO compared to children with bronchial foreign bodies (p<0.05). Additionally, the proportions of neutrophils in BALF were significantly higher in children with PIBO compared to children with bronchial foreign bodies (p<0.05). The levels of IL-27 were negatively correlated with the neutrophil proportions in BALF in children with PIBO (p<0.05), but not in children with bronchial foreign bodies (p>0.05). The present study suggests that a decrease in IL-27 may be associated with an increase in neutrophils in BALF and may contribute to the pathogenesis of PIBO.

Broncho-obstructive syndrome in pediatrician’s practice (clinical cases)

Background. With the development of broncho-obstructive syndrome (BOS), spasm, edema, hypercrinia and bronchial dyscrinia occur. Increasing airflow resistance can complicate the course of diseases of the respiratory system. Broncho-obstructive syndrome coexists many pathologies, including cardiovascular diseases, gastrointestinal diseases and other abnormal developments of internal organs. The causes of this syndrome are diverse, including bronchial asthma, abnormal developments of the bronchopulmonary system, gastroesophageal reflux, cystic fibrosis and congenital heart diseases. The purpose of this study was to analyze and describe clinical cases of pediatric patients with BOS.Clinical cases description. The article presents clinical cases of patients who were treated at the State Budgetary Healthcare Institution of Republic of Crimea “Republic Children’s Clinical Hospital” at different times, who developed BOS against the background of Nijmegen Breakage Syndrome and aspiration of a foreign body (feather from a pillow) into the bronchi. Both clinical cases show the importance of comprehensive, and most importantly, timely diagnostic procedure. In clinical case No. 1, the medical history of patient N. with Nijmegen Breakage Syndrome is described. The pathology was revealed owing to a comprehensive diagnostic procedure. Representatives of patient N. appealed to the State Budgetary Healthcare Institution of Republic of Crimea “Republic Children’s Clinical Hospital” in connection with the development of symptoms of bronchial obstruction. Clinical case No. 2 describes the untimely diagnosis of a radiolucent bronchial foreign body. In this situation, the ambiguity of the clinical picture and, as a result, the search for other pathologies cost the child his life.Conclusion. Broncho-obstructive syndrome is associated with a variety of pathologies that are not limited to problems with the respiratory system. It is important to be able to identify symptoms in patients that will indicate the cause of the developed BOS.

Clinical case of a bronchial foreign body in an 8-year-old child

Clinical case of a bronchial foreign body in an 8-year-old child

Analysis of Anesthesia Management for Removal of Bronchial Foreign Body in a Child

Analysis of Anesthesia Management for Removal of Bronchial Foreign Body in a Child

An unusual case of occult bronchial foreign body in a 9 years child: a stone from seashore

An unusual case of occult bronchial foreign body in a 9 years child: a stone from seashore

Removal of bronchial foreign body in a ventilated preterm infant with flexible bronchoscopy.

Removal of bronchial foreign body in a ventilated preterm infant with flexible bronchoscopy.

A Tracheal Tube Exchanger Container As a Bronchial Foreign Body

A Tracheal Tube Exchanger Container As a Bronchial Foreign Body

Management of Foreign Body Aspiration in Children: Insights From 664 Cases in the Operating Room

Tracheal or bronchial foreign body aspiration is an important emergency o childhood requiring bronchoscopy under general anesthesia. In this retrospective study, bronchoscopy were performed for foreign body aspiration; anesthesia methods, risks, and postoperative complications were evaluated. Children who underwent bronchoscopy with suspicion of a foreign body in the pediatric surgery operating room between January 2010 and December 2021 were included in the study. Six hundred and sixty four children were evaluated. General anesthesia was applied to all bronchoscopy. Demographic characteristics of the patients, type of foreign body, localization of foreign body, distribution of foreign body according to age groups, complications related to anesthesia and surgical process, length of stay in the postoperative intensive care unit, and duration of hospital stay were evaluated. The patients who aspirated foreign bodies most frequently were children aged 1-3 years (73.6%). During bronchoscopy, organic matter (seeds, hazelnuts, peanuts, chickpeas) was the most frequently removed foreign body in children (559 patients). It was observed that foreign bodies were mostly located in the right main bronchus at a rate of 52.4%, the left main bronchus at 28%. The most common anesthesia-related complications were desaturation in 400 patients, hypercarbia in 200 patients, bronchospasm in 108 patients, and respiratory arrest in 2 patients. Many problems may be encountered in foreign body inhalation, and bronchoscopy of these patients should be performed by an experienced anesthesiologist and surgeon at the right time and in the safest way in terms of anesthesia and surgery.

Predictive value of chemokines (CCL 2) in bronchoalveolar lavage fluid for refractory mycoplasma pneumonia in children

BackgroundThere are relatively few studies investigating C-C motif chemokine ligand 2 (CCL2) level in bronchoalveolar lavage fluid (BALF) in children with Mycoplasma pneumoniae pneumonia (MPP), and the relationship between CCL2 level in BALF and refractory mycoplasma pneumoniae pneumonia (RMPP) is unclear. This study aims to explore the relationship between chemokine CCL2 level in BALF and clinical characteristics and clinical outcome in children with MPP.MethodsA total of 51 children with confirmed acute MPP and requiring bronchoalveolar lavage in Department of Pediatrics, Huanghe Sanmenxia Hospital and The First Clinical College of Xinxiang Medical University from October 2021 to February 2023 were selected as the study group. And 11 children with bronchial foreign body were selected as the control group. The study group was divided into the non-refractory mycoplasma pneumoniae pneumonia (NRMPP) group and the RMPP group based on the response to treatment. BALF and clinical data of the patients were collected. And CCL2 levels were tested in the patients. Differences in CCL2 level in BALF and clinical characteristics were tested and compared.ResultsThe CCL2 level in BALF of the study group was higher than that of the control group, with significant difference (P < 0.05). With ROC curve, the area under the curve (AUC) of CCL2 in BALF predicting RMPP was 0.94, the cut-off value was 0.645 ng/ml, the sensitivity was 85%, and the specificity was 94%, and the diagnostic value was better than that of serum CRP and LDH. Logistic regression analysis was used to build the RMPP prediction model, and CCL2 showed good predictive value.ConclusionThe level of CCL2 in BALF was high in children with MPP and had a high predictive value for RMPP. CCL2 can be used as one of the biomarkers for predicting RMPP.

Anesthesia for Extraction of a Bronchial Foreign Body in a Three-Year-Old Child About a Case at the CHU Ignace Deen in Conakry

Introduction: Foreign body inhalation (FB) is a medical-surgical emergency and a frequent cause of respiratory distress in children. Multidisciplinary management combining ENT surgeon and anesthetist-resuscitator. Rigid or flexible bronchoscopy under general anesthesia in total or inhaled intravenous allows the diagnosis and the extraction of the foreign body. The rarity and seriousness of the inhalations seem to us to justify their publication. We report the journey of a case of inhalation of a foreign body consisting of a 6 centimeter point, the extraction of which was only possible thanks to a bronchoscope associated with a Quick air. Observation: this is a child of three in a particular ATCD from 132 km from the capital for inhalation of a foreign body for several days, after passing through two health structures for extraction without success for lack of a specialist. The child is admitted to the CHU Ignace Deen. The clinical, radiographic examination of the thorax revealed a rectilinear opacity of approximately 6 cm next to the right main bronchus. The indication for extraction under general anesthesia was raised. The first attempt at D12 inhalation with a rigid bronchoscope ended in failure. The second attempt two weeks later under inhalation anesthesia with halothane using a rigid bronchoscope associated with Quick air enabled the successful extraction of a tip of approximately 6cm. The immediate evolution was simple. Conclusion: the anesthesia of the child for inhalation of foreign body is a real challenge for the anesthesiologist-resuscitator. The choice of induction technique can be intravenous or inhalation with preservation of spontaneous ventilation. The rigid bronchoscope associated with the Quick air allowed the extraction.

Bronchoscopic findings in dogs with bronchial vegetal foreign bodies: 84 cases (2010-2020).

To describe endoscopic findings, foreign body location, success rate of removal and complications in dogs with bronchial vegetal foreign bodies. The current study retrospectively evaluated the case records of dogs diagnosed with bronchial vegetal foreign bodies at a veterinary hospital centre between January 2010 and April 2020. Information retrieved included breed, sex, age, bodyweight, the season of presentation, presentation and duration of clinical signs, previous removal attempts performed by the referring veterinarian, foreign body location and endoscopic and imaging findings. Eighty-four cases were included. Fifty-nine dogs (70%) presented during spring and summer. Cough (77 of 84; 92%) and fever (15 of 84; 18%) were the main clinical signs. One to 10 bronchial vegetal foreign bodies were removed from each dog. Purulent exudate was observed in the ventral larynx, trachea and bronchi in 49 (65%), 61 (81%) and 71 (95%) dogs, respectively. In most cases, only the barbules of the vegetal foreign bodies were initially observed during endoscopy. The presence of large bronchial nodules or an irregular mucosal surface was a frequent finding (62 of 75; 83%). Mild bleeding was the main complication (58 of 75; 77%) of endoscopic removal, which was successful in 67 of the 84 (80%) cases. Mucosal nodules associated with purulent material within the airways are frequent endoscopic findings in dogs with bronchial vegetal foreign bodies. Bronchoscopy is a relatively safe and useful technique for diagnosis and treatment of bronchial vegetal foreign bodies in dogs.

Coin in the Bronchus Intermedius for 25 Years: Complication of Chronic Foreign Body Aspiration

Chronic bronchial obstructions from inhaled objects are uncommon in the adult population. Long-term complications of foreign body aspiration have included hemoptysis, recurrent pneumonia, empyema, and abscess formation. We report the patient case of a 66-year-old man, with an accidental inhalation of a coin 25 years ago that was never retrieved, who presented with progressive shortness of breath and was found to have an infected lung bulla in the setting of giant bullous emphysema secondary to the chronic right bronchial foreign body.

T-tube気管支内異物例

Airway foreign bodies may cause recurrent pneumonia and atelectasis, which could be fatal; therefore, early diagnosis and removal are important. We report the case of a 76-year-old man who underwent total laryngectomy for laryngeal cancer (cT3N0M0) who presented with a foreign body (T-tube) lodged in his airway. Postoperatively, the permanent tracheostomy was observed to be stenotic, and we inserted a T-tube to maintain patency of the tracheostomy. We observed a gradual increase in sputum accumulation, necessitating frequent suctioning. Follow-up computed tomography performed a few weeks later for comorbid interstitial pneumonia revealed a foreign body in the left main bronchus. We performed bronchoscopy for removal of the bronchial foreign body, which proved to be the T-tube.