F Oğuzkaya1, Y Akçali, C Kahraman, M Bilgin, A Sahin. 1. Department of Thoracic and Cardiovascular Surgery, Erciyes University Medical Faculty, Kayseri, Turkey. okaya@erciyes.edu.tr
Abstract
OBJECTIVE: Tracheobronchial foreign body aspirations comprise the majority of accidental deaths in childhood. Diagnostic delay may cause an increase in mortality and morbidity in cases without acute respiratory failure. We report our diagnostic and therapeutic modalities. METHODS: In our department, bronchoscopy was performed on 548 patients with the diagnosis of tracheobronchial foreign body aspirations (from 1987 to 1997). Of these cases, 55.6% were male and 44.4% female. Their ages ranged from 2 months to 16 years (average 5.5 years). Diagnosis was made on history, physical examination, radiological methods and bronchoscopy. RESULTS: Foreign bodies were localized in the right bronchial tree in 312 cases (56.9%), the left in 126 cases (23.0%) and in the trachea in 62 cases ( 1.3%). Foreign body was not found during bronchoscopy in 48 cases (8.7%). The majority of the foreign bodies were vegetable matters. Foreign bodies were removed with bronchoscopy in all but two cases which underwent limited thoracotomy. In the late period, pulmonary resection was performed in five cases because of irreversible complications. After bronchoscopy, hypoxia developed in four patients, requiring mechanical ventilation. Pneumothorax developed in two cases and mediastinal emphysema in two. Four patients (0.7%) died because of respiratory failure. CONCLUSION: Proper use of diagnostic techniques provides a high degree of success, and the treatment modality to be used depending on the type of the foreign body is mostly satisfactory.
OBJECTIVE: Tracheobronchial foreign body aspirations comprise the majority of accidental deaths in childhood. Diagnostic delay may cause an increase in mortality and morbidity in cases without acute respiratory failure. We report our diagnostic and therapeutic modalities. METHODS: In our department, bronchoscopy was performed on 548 patients with the diagnosis of tracheobronchial foreign body aspirations (from 1987 to 1997). Of these cases, 55.6% were male and 44.4% female. Their ages ranged from 2 months to 16 years (average 5.5 years). Diagnosis was made on history, physical examination, radiological methods and bronchoscopy. RESULTS: Foreign bodies were localized in the right bronchial tree in 312 cases (56.9%), the left in 126 cases (23.0%) and in the trachea in 62 cases ( 1.3%). Foreign body was not found during bronchoscopy in 48 cases (8.7%). The majority of the foreign bodies were vegetable matters. Foreign bodies were removed with bronchoscopy in all but two cases which underwent limited thoracotomy. In the late period, pulmonary resection was performed in five cases because of irreversible complications. After bronchoscopy, hypoxia developed in four patients, requiring mechanical ventilation. Pneumothorax developed in two cases and mediastinal emphysema in two. Four patients (0.7%) died because of respiratory failure. CONCLUSION: Proper use of diagnostic techniques provides a high degree of success, and the treatment modality to be used depending on the type of the foreign body is mostly satisfactory.