Complications of Long-Standing Foreign Body in the Airway and Their Outcomes After Endoscopic Management: An Experience of 20 Cases
| Autor: | Simmi K. Ratan, Gulshan Rai Sethi, Shandip Kumar Sinha, Satish Kumar Aggarwal, Anjan Kumar Dhua |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Bronchi Endoscopic management Bronchoscopy medicine Humans Child Retrospective Studies Lung medicine.diagnostic_test business.industry Bronchomalacia Infant Retrospective cohort study Pulmonologist Foreign Bodies medicine.disease Surgery Treatment Outcome medicine.anatomical_structure Child Preschool Chronic Disease Female Radiology Foreign body Tomography X-Ray Computed business Airway Follow-Up Studies |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 25:81-87 |
| ISSN: | 1557-9034 1092-6429 |
| Popis: | To study the outcomes after endoscopic treatment of chronic foreign bodies (FBs) in the airway.A retrospective study (2008-2013) of 20 cases with chronic airway FBs (2 weeks) was done with emphasis on endoscopic management. All cases were initially evaluated by the pediatric pulmonologist. Flexible and rigid bronchoscopy was done for diagnosis and retrieval, respectively. The techniques of FB retrieval, problems encountered, and their solutions were analyzed. Follow-up flexible bronchoscopy was done in symptomatic cases. Outcomes were assessed in terms of successful removal of the FB, clinical recovery, lung expansion, and need for further procedures.Twenty cases (16 boys, 4 girls) with a mean age of 7 years had a chronic airway FB diagnosed on chest X-ray (n=6) and flexible bronchoscopy (n=14). Six cases had computed tomography evaluation. On rigid bronchoscopy, the FB was successfully retrieved in 16 cases. Two cases required open surgery for FB-induced tracheoesophageal fistula. One case required pneumonectomy because of a battery eroding into the lung parenchyma. One patient died. Of the 16 who had successful retrieval, 11 recovered with full lung expansion. Four recovered after additional bronchoscopic procedures (cauterization of granulation [n=2] and balloon dilatation of bronchial stenoses [n=2]). One case required pneumonectomy for persistent collapse despite multiple dilatations.An airway FB producing chronic respiratory symptoms may be missed because of lack of definite history of an inhaled FB. Clinical suspicion and flexible bronchoscopy are instrumental in diagnosis. Treatment is challenging because of chronicity-related complications and requires innovative ideas to make best use of the available urologic and bronchoscopic equipment. Addition of tracheotomy provides safety in difficult cases. Bronchoscopic removal leads to clinical and radiological recovery in most cases. |
| Databáze: | OpenAIRE |
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