1
|
He Q, Huang H, Yang H, Shen Y. Pulmonary destruction due to retained bronchial foreign body in a 13-year-old boy. Pediatr Pulmonol 2024. [PMID: 39221887 DOI: 10.1002/ppul.27238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/30/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Qianqian He
- Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Han Huang
- Respiratory Department, Children's Hospital Affiliated to Zhengzhou University, Henan Children's hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Haiming Yang
- Respiratory Department II, National Clinical Research Center for Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Yuelin Shen
- Respiratory Department II, National Clinical Research Center for Respiratory Diseases, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| |
Collapse
|
2
|
Alshaikh AA, Alhelali A, Hassan AA, Asiri MYA, Bukhari LKT, Hassan AAH, Hassan AAH, Alqahtani RSH, AlQahtani RY, Ghazy RM. Community experience and awareness regarding foreign body aspiration in Asir region, Kingdom of Saudi Arabia. Medicine (Baltimore) 2024; 103:e38869. [PMID: 39093731 PMCID: PMC11296466 DOI: 10.1097/md.0000000000038869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/19/2024] [Indexed: 08/04/2024] Open
Abstract
Foreign body aspiration (FBA) is a serious preventable pediatric health problem and one of the main causes of accidental death in children. Although unusual in adults, it is often overlooked as a cause of airway obstruction with serious consequences. This study assessed awareness and previous FBA experiences in the Asir community, Kingdom of Saudi Arabia. Using validated questionnaire, an annonymous online survey was conducted among 870 people aged 18 years and above. The questionnaire was used to collect data about the personal and sociodemographic characteristics of the respondents, as well as their experiences with FBA, and participants' knowledge and perceived seriousness of FBA. The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%The level of knowledge was deemed good if the score ranged between 60% and 100%, and bad if the score fell below 60%. The majority of the participants (79.7%) were females, 48.1% were aged 18 to 30 years, 72.9% had university degree, 30.6% were students, 26.9% worked in the educational sector, 43.6% reported monthly income of <5000 Saudi Riyals and 19.8% of them identified themselves as healthcarepractitioners. Although the community experience with FBA was considerably high (70.6%) among the study participants, their awareness levels about FBA were deficient. Only 24.7% of the respondents had good knowledge of FBA. Older age, being a health practitioner, and perceiving FBA as a serious incident were significantly associated with good knowledge (P < .001). The findings of this study indicate an urgent need to raise community awareness of FBA. To reduce FBA morbidity and mortality, health education efforts in community and healthcare settings are required to educate people about the seriousness and importance of early diagnosis and management of the condition.
Collapse
Affiliation(s)
- Ayoub Ali Alshaikh
- Family & Community Medicine Department, King Khalid University, College of Medicine Abha, Abha, Saudi Arabia
| | - Abdullah Alhelali
- Abha Children Hospital, Aseer Central Hospital, Head of Airway/Laryngology Unit – Aseer, Central Hospital, Abha, Saudi Arabia
| | - Abdulrahim Ali Hassan
- Otorhinolaryngology, Head and Neck Surgery, Armed Forced Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | | | | | | | | | | | | | - Ramy Mohamed Ghazy
- Family & Community Medicine Department, King Khalid University, College of Medicine Abha, Abha, Saudi Arabia
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| |
Collapse
|
3
|
Ozturk K, Boybeyi O, Soyer T. The Effect of COVID-19 Pandemic on Foreign Body Aspiration. Thorac Cardiovasc Surg 2023; 71:504-508. [PMID: 36858068 DOI: 10.1055/s-0043-1763285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
BACKGROUND This article evaluates the effect of coronavirus disease 2019 (COVID-19) pandemic on clinical course and management of cases that underwent bronchoscopy for suspected foreign body aspiration (FBA) in children. METHODS The patients who underwent bronchoscopy with a presumptive diagnosis of FBA between July 2018 and December 2021 were evaluated for demographic features, clinical findings, management details, and outcomes. Patients were divided in two groups: before pandemic (group A) and during pandemic (group B). RESULTS In total 79 cases with a median age of 5 years (4-5) in group A (n = 47) and 3 years (2-3) in group B (n = 32) were included (p < 0.05). The witnessed aspiration was significantly higher in group B (90.6%) when compared to group A (53%) (p < 0.05). Admission time was less than 48 hours in 30 cases (64%) in group A and 23 cases (72%) in group B (p = 0.002). The intervention time was less than 24 hours in 30 cases (64%) in group A, 9 cases (28%) in group B (p = 0.002). Bronchoscopy was performed after COVID-19 polymerase chain reaction (PCR) testing in all cases in group B. The positive FBA rate was 38% (n = 18) in group A, and 59% (n = 19) in group B (p = 0.067). CONCLUSION During pandemics, bronchoscopy for FBA was performed in younger infants than before pandemic and witnessed aspiration was significantly more common in that period. The differences in age groups and symptoms may be explained by spending more time at home during pandemics. Waiting for the PCR test results causes delays in the intervention. However, this delay did not cause any respiratory distress.
Collapse
Affiliation(s)
- Kubra Ozturk
- Department of Pediatric Surgery, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Ozlem Boybeyi
- Department of Pediatric Surgery, Medical Faculty, Hacettepe University, Ankara, Turkey
| | - Tutku Soyer
- Department of Pediatric Surgery, Medical Faculty, Hacettepe University, Ankara, Turkey
| |
Collapse
|
4
|
Shir A, Micha A, Novik FE, Elizabeth HS, Shani P, Maija L, Inbal R, Aviv G, Yotam D, Inbal GT. Comparison of chest X-ray interpretation by pediatric pulmonologists, pediatric radiologists, and pediatric residents in children with suspected foreign body aspiration-a retrospective cohort study. Eur J Pediatr 2023:10.1007/s00431-023-04943-z. [PMID: 37081195 DOI: 10.1007/s00431-023-04943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
Chest X-ray (CXR) is an important tool in the assessment of children with suspected foreign body aspiration (FBA), although it can falsely be interpreted as normal in one-third of the cases. The aim of this study is to evaluate the positive predictive value of CXR in children hospitalized with suspected FBA, when interpreted by three disciplines: pediatric pulmonology, pediatric radiology, and pediatric residents. This is a retrospective study that included children aged 0-18 years, admitted with suspected FBA, between 2009 and 2020 in one tertiary center. All patients underwent CXR and a flexible/rigid bronchoscopy for the definitive diagnosis of FBA, up to 1 week apart. Two physicians from each discipline interpreted the CXR, independently. Intra-raters' and inter-raters' agreements were assessed. Sensitivity, specificity, and area under the curve (AUC) were calculated for each discipline. Four hundred seventy-three children were included in the study, 175 (37%) with FBA and 298 (63%) without FBA on flexible/rigid bronchoscopy. The most common radiological findings, as interpreted by a pediatric pulmonologist, were unilateral hyperinflation (47%), radiopaque FB (37.6%), lobar atelectasis (10.3%), unilateral hyperinflation with atelectasis (3.4%), and lobar consolidation (1.7%). Intra-raters' agreement ranged from 0.744 (p < 0.001) among pediatric pulmonologists to 0.326 (p < 0.001) among pediatric radiologists. AUC for predicting FBA based on a CXR was 0.81, 0.77, and 0.7 when interpreted by pediatric pulmonologists, pediatric residents, and radiologists, respectively (p < 0.001). CONCLUSIONS CXR has a high positive predictive value and independently predicts FBA in children; however, normal CXR should not rule out FBA. Predictability is variable among different disciplines. WHAT IS KNOWN • Chest X-ray is an important tool in the assessment of children with suspected foreign body aspiration (FBA). • Chest X-ray can be interpreted as normal in one-third of the cases. WHAT IS NEW • Chest X-ray independently predicts FBA in children, with a high positive predictive value. • The ability of chest x-ray to predict FBA in children differs between pediatric residents, pediatric radiologists, and pediatric pulmonologists.
Collapse
Affiliation(s)
- Avraham Shir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviram Micha
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Hoch Sarah Elizabeth
- Department of Radiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Pozailov Shani
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Levin Maija
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
| | - Raviv Inbal
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Goldbart Aviv
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dizitzer Yotam
- Departmant of Pediatrics, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Golan-Tripto Inbal
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| |
Collapse
|
5
|
Su S, Zhang H, Xiao L, Yao H, Ding L. Correlative Factors for Types of Tracheobronchial Foreign Bodies Encountered in Children. EAR, NOSE & THROAT JOURNAL 2023:1455613231167244. [PMID: 37010488 DOI: 10.1177/01455613231167244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE To characterize the correlative factors for types of tracheobronchial foreign bodies (TFBs) encountered in children. METHODS All included patients diagnosed with TFB underwent rigid bronchoscopy as the first surgery in the Children's Hospital of Chongqing Medical University. The data of 1026 patients aged 0-18 years were retrospectively collected between February 2019 and January 2022. RESULTS About 94.44% of the children with TFB had organic FBs, among which, peanuts were the most common FBs, followed by melon seeds and walnuts. The most common inorganic FBs included pen points or caps, plastic toys, and plastic papers. As compared to the children with organic FBs, those with inorganic FBs consisted of a higher proportion of children aged ≥3 years old, a time before surgery of >7 days, dyspnea, FBs size of >10 mm, longer operation time, more than two operation procedures, and atelectasis. On the other hand, the proportion of children with aspiration history, cough, and obstructive emphysema in the inorganic FB group was lower as compared to the organic FBs (P< .05). CONCLUSIONS The related factors related to the patient's characteristics, symptoms, operation situations, and preoperative complications can be predicted based on the identification of FB type.
Collapse
Affiliation(s)
- Shuping Su
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hengci Zhang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling Xiao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling Ding
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| |
Collapse
|
6
|
Ding L, Su X, Yang D, Yao H, Xiao L. Risk factors for difficult removal of tracheobronchial foreign bodies in children by rigid bronchoscopy. Int J Pediatr Otorhinolaryngol 2023; 168:111539. [PMID: 37023557 DOI: 10.1016/j.ijporl.2023.111539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To characterize the risk factors for difficult removal of tracheobronchial foreign body (FB) by rigid bronchoscopy in children. METHODS We retrospectively analyzed clinical data of 1026 pediatric patients (age: 0-18 years) diagnosed with tracheobronchial FB between September 2018 and August 2021. All patients underwent rigid bronchoscopy as the first intervention at our hospital. RESULTS Children aged 1-3 years accounted for 83.7% cases in our cohort. The most common symptoms were cough and wheeze. FBs were more frequently found in the right bronchus, and trachea FBs accounted for only 8.19% cases. The success rate of rigid bronchoscopy in a single attempt was 97.27%. 12.18% of the cases were defined as difficult removal of FB. On univariate analysis, age, CT findings (pneumonia), type of FB, diameter of FB, FB location, granulation tissue formation, and the seniority of the surgeon were identified as risk factors for difficult removal of tracheobronchial FBs. On multivariate analysis, age ≥3 years, FB diameter ≥10 mm, FBs located in left bronchus, multiple FBs, granulation tissue, and the seniority of surgeon (<3 years, ≥5 years) were independent risk factors for difficult removal. CONCLUSIONS Age, FB diameter, location of FB, granulation tissue formation, and the seniority of the surgeon were risk factors for difficult removal of FBs by rigid bronchoscopy.
Collapse
Affiliation(s)
- Ling Ding
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiujing Su
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Dazhi Yang
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Ling Xiao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
| |
Collapse
|
7
|
Greenlund L, Borden A, Nickel A, Arms J, Kavanagh K, McCoy J, Shaffer A, Snyder V, Tobey A, Roby B. Pediatric peanut aspirations before and after 2015 recommendation for early peanut exposure. Int J Pediatr Otorhinolaryngol 2023; 168:111518. [PMID: 37023556 DOI: 10.1016/j.ijporl.2023.111518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVES To investigate if there has been an increase in peanut foreign body aspirations (FBA) in children since the publication of the Learning Early About Peanut Allergy (LEAP) trial, which revealed that early exposure to peanut-containing foods prevented peanut allergies in children at risk of atopic disease. METHODS Retrospective chart reviews were conducted separately at two pediatric institutions. Institutions One and Two reviewed children less than 7 years old who underwent bronchoscopy for FBA over ten-year periods between January 2007 and September 2017 and November 2008 and May 2018, respectively. The proportion of FBAs attributed to peanuts was compared before and after the publication LEAP. RESULTS Out of 515 reviewed cases, there was no change in pediatric peanut aspirations prior to and following the LEAP trial and AAP guideline change (33.5% vs 31.4%, p = 0.70). At Institution One, 317 patients met inclusion criteria. When comparing FBAs before and after LEAP, there were no significant changes in the rate of peanut aspiration (53.5% vs. 45.1%, p = 0.17). Institution Two also found no significant increase in the rate of peanut aspirations before and after the Addendum Guidelines (41.4% vs. 28.6%, p = 0.65) upon review of 198 cases. CONCLUSIONS Multiple institutions demonstrated a non-significant change in the rate of peanut FBAs following the AAP recommendation. Given that peanuts comprise a large proportion of FBAs, it is important to continue to track peanut aspirations. Longer term data tracking is needed from more institutions to further understand how recommendations from other specialties and the media impacts pediatric aspiration outcomes.
Collapse
Affiliation(s)
| | - Amy Borden
- Children's Minnesota, Department of Pediatric Emergency Medicine, USA
| | | | - Joseph Arms
- Children's Minnesota, Department of Pediatric Emergency Medicine, USA
| | - Katherine Kavanagh
- Connecticut Children's Hospital, Department of Otolaryngology, Head and Neck Surgery, USA
| | - Jennifer McCoy
- University of Pittsburg Medical Center, Department of Pediatric Otolaryngology, USA
| | - Amber Shaffer
- University of Pittsburg Medical Center, Department of Pediatric Otolaryngology, USA
| | - Vusala Snyder
- University of Pittsburg Medical Center, Department of Pediatric Otolaryngology, USA
| | - Allison Tobey
- University of Pittsburg Medical Center, Department of Pediatric Otolaryngology, USA
| | - Brianne Roby
- Children's Minnesota, Department of Pediatric ENT and Facial Plastic Surgery, USA; University of Minnesota, Department of Otolaryngology- Head and Neck Surgery, USA.
| |
Collapse
|
8
|
Parvar SY, Sarasyabi MS, Moslehi MA, Priftis KN, Cutrera R, Chen M, Lili Z, Gonuguntla HK, Joseph T, Alajmi M, Alshammari S, Singh V, Parakh A, Indawati W, Triasih R, Fasseeh N. The characteristics of foreign bodies aspirated by children across different continents: A comparative review. Pediatr Pulmonol 2023; 58:408-424. [PMID: 36373422 DOI: 10.1002/ppul.26242] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/05/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Foreign body aspiration (FBA) is a common issue in pediatric emergencies, with regional variations. Various cultures and foods, parents' and physicians' inadequate experience, and lack of bronchoscopy equipment are some attributable factors in the regional variation of FBA. AIM To more accurately represent the demographic characteristics of aspirated foreign bodies (FBs) across various continents, this review attempted to provide organized information based on the reviewed articles. METHODOLOGY A search was conducted in PubMed/PubMed Central, EMBASE, and google scholar. From the 36 included articles, information on age, gender, bronchoscopy type, type of FB, location, history of choking, and time elapsed between aspiration and admission were extracted. RESULTS A total of 14,469 cases were evaluated. According to the findings, children under two accounted for more than 75% of FBAs. Nuts and seeds were the most common FBs in most countries, whereas plastic and metal objects had higher rates in Brazil, and calcified objects were more prevalent in Thailand. The right bronchus was the most frequent location, and rigid bronchoscopy was the most often utilized type of bronchoscope. In addition, a significant percentage of patients were referred to the emergency rooms in the first 12-24 h following the aspiration incident. Moreover, Asian patients reported more choking history, and Europeans had fewer witnesses of FBA. CONCLUSIONS There is a lack of standardized reporting systems and organized guidelines in pediatric FBA. To select the ideal time for endoscopies and create educational programs, a collaboration between experienced researchers, pediatric pulmonologists, radiologists, and otolaryngologists is required.
Collapse
Affiliation(s)
| | | | - Mohammad Ashkan Moslehi
- Pediatric Interventional Pulmonology Division, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kostas N Priftis
- Children's Respiratory and Allergy Unit at National and Kapodistrian University of Athens, Zografou, Greece
| | - Renato Cutrera
- Pediatric Respiratory Department, Bambino Gesù Pediatric University Hospital, Rome, Italy
| | - Meng Chen
- Pediatric Interventional Respiratory Division, Qilu Children University Hospital, Shandong University, Jinan, China
| | - Zhong Lili
- Pediatric Respiratory Department, The Children's Medical Center of Hunan Provincial People's Hospital, Hunan University of Medical Sciences, Changsha, Hunan, China
| | - Hari K Gonuguntla
- Division of Interventional Pulmonology, Yashoda Hospitals, Hyderabad, India
| | - Tinku Joseph
- Interventional Pulmonology Amrita Institute of Medical Sciences, Kochi, Kerala, India
| | - Mohsen Alajmi
- Pediatric Respirology and Interventional Pulmonology, Ahmadi Hospital, Al Ahmadi, Kuwait
| | - Salman Alshammari
- Department of Pediatrics, Pediatric Intensive Care Unit, Adan Hospital, Hadiya, Kuwait
| | - Varinder Singh
- Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Childrens Hospital, Delhi, India
| | - Ankit Parakh
- Pediatric Respiratory Division, BLK Max Hospital, New Delhi, India
| | - Wahyuni Indawati
- Child Health Department, Respirology Division, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Rina Triasih
- Department of Pediatric, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada Dr. Sarjito Hospital, Yogyakarta, Indonesia
| | - Nader Fasseeh
- Respiratory and Allergy Unit, Faculty of Medicine, Alexandria Universty, Alexandria, Egypt
| |
Collapse
|
9
|
Muacevic A, Adler JR, Md Nor K, Abu bakar S, Mat Baki M. Supraglottic Foreign Body Missed for One Month in a Child. Cureus 2023; 15:e33870. [PMID: 36819404 PMCID: PMC9933417 DOI: 10.7759/cureus.33870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 01/19/2023] Open
Abstract
Foreign body (FB) aspiration in children can result in serious complications that can lead to even death. We present a case of a one-year-old girl child with a history of choking one month prior while she was feeding. A bolus of rice was removed at a local clinic. Consequently, within 24 hours, she developed hoarseness and noisy breathing which was treated as an upper respiratory tract infection at two different clinics. This case report aims to highlight the need for otolaryngology consultation in a child with non-resolving respiratory symptoms following episodes of choking. This will prompt an immediate surgical intervention that could prevent potential morbidity and mortality as a result of a compromised airway.
Collapse
|
10
|
Caffarelli C, Santamaria F, Piro E, Basilicata S, Delle Cave V, Cipullo M, Bernasconi S, Corsello G. New insights in pediatrics in 2021: choices in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, haematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine. Ital J Pediatr 2022; 48:189. [PMID: 36435791 PMCID: PMC9701393 DOI: 10.1186/s13052-022-01374-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/25/2022] [Indexed: 11/28/2022] Open
Abstract
In this review, we report the developments across pediatric subspecialties that have been published in the Italian Journal of Pediatrics in 2021. We highlight advances in allergy and immunology, critical care, endocrinology, gastroenterology, genetics, hematology, infectious diseases, neonatology, neurology, nutrition, palliative care, respiratory tract illnesses and telemedicine.
Collapse
Affiliation(s)
- Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Via Gramsci 14, Parma, Italy.
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Ettore Piro
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
| | - Simona Basilicata
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Valeria Delle Cave
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Marilena Cipullo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | | | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care G. D'Alessandro, University of Palermo, Palermo, Italy
| |
Collapse
|
11
|
Evaluation of the relevance of interhospital transfer medicalization in the suspicion of foreign body aspiration in children. Arch Pediatr 2022; 29:615-619. [DOI: 10.1016/j.arcped.2022.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/13/2022] [Accepted: 05/12/2022] [Indexed: 11/21/2022]
|
12
|
Foreign Body Aspiration in Children-Diagnostic Clues through a Clinical Case. Pediatr Rep 2022; 14:81-85. [PMID: 35225881 PMCID: PMC8883880 DOI: 10.3390/pediatric14010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/23/2022] [Accepted: 02/07/2022] [Indexed: 11/17/2022] Open
Abstract
Foreign body aspiration is common in the pediatric age group, especially in males. Despite the high frequency of this potentially life-threatening event, it is not always easy to recognize it given the high variability of the clinical presentation and the potential of "pauci-symptomatic" inhalation. Moreover, a variable latency of the onset of symptoms since the moment of aspiration may be possible determining difficulties in the identification of the inhalation on an anamnestic basis. We describe the case of a 19-month-old boy who accessed the emergency room initially for a head trauma. The clinical evaluation, however, revealed an unexplained serious respiratory distress needing tracheal intubation. After our evaluation, we hypothesized that the severe respiratory distress determined an altered state of consciousness with following head trauma. The radiological findings raised the suspicion of foreign body aspiration for the presence of an atelectasis of the entire left lung. The computed tomography showed an abrupt interruption of the main bronchus at 12 mm from the hull. The following bronchoscopy identified an almond of 2 cm. We will review the literature to underline the diagnostic issues behind foreign body aspiration in children by highlighting the diagnostic clues that are helpful for emergency clinicians in the management of this condition.
Collapse
|
13
|
Pietraś A, Markiewicz M, Mielnik-Niedzielska G. Rigid Bronchoscopy in Foreign Body Aspiration Diagnosis and Treatment in Children. CHILDREN (BASEL, SWITZERLAND) 2021; 8:1206. [PMID: 34943402 PMCID: PMC8700144 DOI: 10.3390/children8121206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/30/2022]
Abstract
Foreign body aspiration in children is a common condition and can bring about serious undesired results. Fast and accurate diagnosis and foreign body extraction from airways are essential. We performed a retrospective study on rigid bronchoscopy outcomes due to suspected foreign body aspiration. A total of 66 children were admitted to the Chair and Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin between 2015 and 2020 and underwent rigid bronchoscopy in general anesthesia due to suspected foreign body aspiration. We analyzed the data, including patients age and sex, reported complaints, and bronchoscopy findings. Analyzed children were aged from 8 months to 17 years old; 74.24% of them were under 3 years old during the procedure, and most of the operated patients were males. In 36.36% cases, no foreign body was identified, and 57.14% foreign bodies were located in right main bronchus. A total of 80.95% of foreign bodies extracted from airways were organic, mostly nuts. Diagnosis and treatment of suspected foreign body aspiration requires consistent cooperation between pediatricians, pulmonologists, anesthesiologists, and otolaryngologists.
Collapse
Affiliation(s)
- Aleksandra Pietraś
- Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin, 20-093 Lublin, Poland; (M.M.); (G.M.-N.)
| | | | | |
Collapse
|
14
|
A new scoring system and clinical algorithm for the management of suspected foreign body aspiration in children: a retrospective cohort study. Ital J Pediatr 2021; 47:194. [PMID: 34583774 PMCID: PMC8480080 DOI: 10.1186/s13052-021-01147-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cases of foreign body aspiration in children may be encountered in emergency departments. A suggestive history is important in diagnosing aspirated foreign body owing to the difficulty in making a diagnosis on the basis of an abnormal physical examination or chest radiography alone. The aim of this study was to examine the sensitivity and specificity of the presenting symptoms, physical examination, and radiologic findings as predictors of foreign body aspiration in children. In addition, a feasible simple algorithm with a scoring system was generated to indicate bronchoscopic investigation. METHODS In a retrospective cohort, medical records of patients aged less than 16 years with suspected foreign body aspiration who underwent flexible or rigid bronchoscopy were included. Data including age, sex, symptoms, physical examination findings, radiological features, nature and location of the foreign body, and outcome of the bronchoscopy were collected, and multivariable binary logistic regression analysis was employed for prediction of foreign body aspiration. RESULTS A total of 203 children were included, and the model showed excellent discrimination power for positive foreign body aspiration (area under the curve = 0.911) with an accuracy, sensitivity, and specificity of 86.2, 90.6, and 76.6%, respectively. The total weighted risk score at a cut-off > 2 showed a significant good power of discrimination (area under the curve = 0.879), with a sensitivity of 79.9% and specificity of 84.4%. Accordingly, a clinical algorithm was recommended. CONCLUSIONS The proposed scoring system and clinical algorithm might help in decision making with regard to the need and type of bronchoscopy in children presenting with potential foreign body aspiration. However, further prospective multicenter studies should be conducted to validate this scoring system.
Collapse
|
15
|
Reyad HM, El-Deeb ME, Abbas AM, Sherief D, Elagamy OA. Foreign Body Aspiration in Egyptian Children Clinical, Radiological and Bronchoscopic Findings. J Multidiscip Healthc 2021; 14:2299-2305. [PMID: 34465998 PMCID: PMC8403025 DOI: 10.2147/jmdh.s326967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Foreign body aspiration (FBA) is a frequent cause of childhood morbidity and mortality. Diagnosis of FBA is challenging in the absence of a witnessed aspiration event. The aim of this study was to determine the accuracy of presenting symptoms as well as physical and radiologic findings as predictors of FBA in children. Thus, indications for bronchoscopy could be determined in such cases. Methods This retrospective cohort study was conducted in the ENT department, Kafr-elsheikh University Hospital. The medical records of patients younger than 16 years old who underwent rigid bronchoscopy for suspected FBA were included. Data including age, gender, symptoms, physical examination findings, radiological features, nature and location of foreign body, and outcome of the bronchoscopy were collected. Results This study included 130 patients, 105 (80.8%) patients were positive for the presence of a foreign body in their airways. Foreign bodies were most frequently (43.8%) lodged in the right main bronchus, and nuts (66.7%), were the most commonly retrieved. Multivariate regression analysis identified the presence of suggestive signs or symptoms as independent predictors of FBA on rigid bronchoscopy. Conclusion Objective finding of clinical signs eg unilateral wheezes on chest examination in the presence of symptoms such as a sudden cough, dyspnea, and hoarseness could predict FBA and help physicians in deciding bronchoscopy.
Collapse
Affiliation(s)
- Heba M Reyad
- Department of Pediatrics, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Mohamed E El-Deeb
- Department of Otorhinolaryngology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Ahmed M Abbas
- Department of Pediatrics, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Dalia Sherief
- Department of Clinical Pathology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Osama A Elagamy
- Department of Pediatrics, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| |
Collapse
|
16
|
Liu Y, Ning J. Blood cast of the left bronchial tree caused by foreign body aspiration in a 12-year-old boy. Pediatr Pulmonol 2021; 56:2789-2790. [PMID: 34171174 DOI: 10.1002/ppul.25526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/25/2021] [Accepted: 05/29/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Yu Liu
- Department of Pediatrics, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Jinbo Ning
- Department of Pediatrics, Chongqing University Three Gorges Hospital, Chongqing, China
| |
Collapse
|
17
|
Gan W, Xiao N, Feng Y, Zhou D, Hu J, Liu S, Zou J. Clinical analysis of tracheobronchial foreign body aspiration in children: a focus on external and intrinsic factors. BMC Surg 2021; 21:108. [PMID: 33658017 PMCID: PMC7927229 DOI: 10.1186/s12893-021-01089-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 02/03/2021] [Indexed: 02/08/2023] Open
Abstract
Background Tracheobronchial foreign body aspiration (TFBA) is a critical disease in children and is extremely dangerous, even life-threatening. The factors affecting the occurrence and prognosis of TFBA are complex. The purpose of this study is to examine the external and intrinsic factors affecting clinical features of TFBA in West China and propose potential effective intervention measures. Methods We retrospectively analyzed the clinical data of pediatric patients diagnosed with TFBA with foreign bodies (FBs) removed by rigid bronchoscopy under general anesthesia at the otolaryngology department from December 2017 to November 2018. The data included age, sex, clinical symptoms, type and location of FB, guardians, prehospital duration and residence of these pediatric patients. Results The ratio of males (72) to females (53) was 1.4:1. Children aged from 1 to 3 years accounted for 76% (95/125) of patients. Cough, continuous fever and dyspnea were the primary symptoms. The right primary bronchus was the most common location of FB detection by rigid bronchoscopy (67 cases, 53.6%). Organic FBs were most common in our study. Guardians of patients significantly differed in the rural (parents 16, grandparents 31) and urban (parents 52, grandparents 26) groups (χ2 = 12.583, p = 0.000). More children in the rural group than in the urban group had a treatment delay longer than 72 h. More children in the group with no history of FB aspiration (12, 25%) than in the group with prior FB aspiration had a treatment delay longer than 72 h. Conclusion Pediatric TFBA is a common emergency in otolaryngology. Age, sex, tracheobronchial anatomy and other physiological elements were defined as intrinsic factors, while guardians, residence, FB species and prehospital time were defined as external factors of TFBA. External and intrinsic factors both influence the occurrence and progression of TFBA. It is extremely important to take effective measures to control external factors, which can decrease morbidity and mortality.
Collapse
Affiliation(s)
- Weigang Gan
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Ning Xiao
- Health Management Center, Sichuan Provincial People's Hospital, Chengdu, Sichuan, People's Republic of China
| | - Yiyuan Feng
- Department of Otorhinolaryngology-Head and Neck Surgery, Qianwei People's Hospital, Sichuan, 614400, Leshan, People's Republic of China
| | - Danmei Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Qianwei People's Hospital, Sichuan, 614400, Leshan, People's Republic of China
| | - Juanjuan Hu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Shixi Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Jian Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, People's Republic of China.
| |
Collapse
|
18
|
Abstract
Foreign body aspiration is a true medical emergency and is the fifth most common cause of mortality due to unintentional injury in the United States. Children who have aspirated a foreign body may present with a variety of symptoms, from mild irritation and cough to respiratory failure. Treatment is removal of the foreign body, often via rigid bronchoscopy. Clinicians must have a high degree of suspicion to ensure a foreign body aspiration is not missed on initial presentation.
Collapse
|
19
|
Cheng J, Li C, Corsini EM, Antonoff MB, Hekmat K, Liu L. Left destroyed lung caused by a pen cap in the left lower lobe bronchus "swallowed" 25 years ago. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:711. [PMID: 31930110 DOI: 10.21037/atm.2019.11.64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A delayed diagnosis of tracheobronchial foreign body aspiration (FBA) may result in severe respiratory complications such as pneumonia, bronchiectasis, and atelectasis. Here, we present a rare case of a left lung destruction caused by a pen cap that remained in the left lower lobe bronchus for 25 years and was previously misdiagnosed as cavitary tuberculosis. The foreign body was not detected in bronchoscopic examination prior to surgery due to severe stenosis of the left main bronchus. The foreign body was found incidentally while the patient was undergoing left pneumonectomy. To the best of our knowledge, this the second longest delay to diagnosis of FBA reported. This case also exemplifies the grave consequences of misdiagnosis of FBA.
Collapse
Affiliation(s)
- Jiahan Cheng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China.,Department of Pathology, School of Medicine, Stanford University, Palo Alto, CA,94304, USA
| | - Chuan Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
| | - Erin M Corsini
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Khosro Hekmat
- Department of Cardiothoracic Surgery, University of Cologne, 50937 Cologne, Germany
| | - Lunxu Liu
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.,Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu 610041, China
| |
Collapse
|
20
|
Wong M, Bhatia R. A 9-month-old with wheezing and acute hypoxic respiratory failure. Clin Case Rep 2019; 7:976-980. [PMID: 31110728 PMCID: PMC6509999 DOI: 10.1002/ccr3.2134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/02/2019] [Accepted: 03/07/2019] [Indexed: 11/06/2022] Open
Abstract
Foreign body aspiration remains a diagnostic challenge, especially in an infant. While acute onset wheezing is highly suggestive of an aspiration, wheezing carries a broad differential diagnosis resulting in frequent misdiagnoses. Many cases present with a range of nonspecific findings and normal imaging, stressing the importance of a high index of suspicion.
Collapse
Affiliation(s)
- Matthew Wong
- Pulmonary MedicineAkron Children’s HospitalAkronOhio
| | - Rajeev Bhatia
- Pulmonary MedicineAkron Children’s HospitalAkronOhio
| |
Collapse
|
21
|
GONZÁLEZ-HERRERO M, RUIS-HIERRO C, CHAMORRO-JUÁREZ R, ORTEGA-ESCUDERO M, GUTIERREZ-DUEÑAS JM. Cuerpo extraño en la vía aérea en la edad pediátrica. REVISTA ORL 2017. [DOI: 10.14201/orl.15838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|