1
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Oruqaj G, Krombach G, Gattenloehner S, Herold S, Vadász I, Seeger W, Tello K, Hecker M. Adenomatous hyperplasia induced by chronic cherry pit retention mimicking an endobronchial tumor-case series and systematic review of literature. Front Med (Lausanne) 2024; 11:1404951. [PMID: 39086956 PMCID: PMC11288952 DOI: 10.3389/fmed.2024.1404951] [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] [Received: 03/21/2024] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Endobronchial foreign body aspiration is not common in adults, but it is a life-threatening event. Recurrent pneumonias by chronic retention of foreign body often lead to initial medical presentation of the patient. However, lymphoplasmacellular bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia with complete or partial blockage of lobar bronchus mimicking lung tumor is rare in literature, and this particular condition is often misdiagnosed. Case presentation we report our experience in the diagnostic and management of two elderly patients with recurrent pneumonia, admitted in hospital for further examination. In both patients, with no history of aspiration, the cherry pit was detected during bronchoscopy and recanalization with flexible cryoprobe, surrounded by purulent secretion, occluding completely the right upper lobe in the first case, and partially the left lower lobe associated with persistent actinomycosis in the second case, with signs of local inflammation, bronchial adenomatous hyperplasia mimicking lung tumor at initial bronchoscopic examination. Histology showed a lymphoplasmacellullar bronchitis with adenomatous hyperplasia and squamous epithelium metaplasia because of chronic retention of foreign body. Conclusion Bronchoscopy examination should be considered in cases where there is an unresolved chronic cough with recurrent pneumonia or persistent actinomycosis in patients with high risk. Cryoprobe is a safe and feasible approach for treatment of airway obstructions due to chronic foreign body retention. Furthermore, relevant findings are discussed here, along with a review of the pathologic alterations and treatment modalities seen in chronic retention of foreign body and airway injury.
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Affiliation(s)
- Gani Oruqaj
- Department of Internal Medicine, Medical Clinic II, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Gabriele Krombach
- Department of Radiology, University Hospital Giessen, Giessen, Germany
| | - Stefan Gattenloehner
- Department of Pathology, Justus-Liebig- University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
| | - Susanne Herold
- Department of Internal Medicine V, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - István Vadász
- Department of Internal Medicine, Medical Clinic II, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Werner Seeger
- Department of Internal Medicine, Medical Clinic II, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Khodr Tello
- Department of Internal Medicine, Medical Clinic II, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
| | - Matthias Hecker
- Department of Internal Medicine, Medical Clinic II, Universities of Giessen and Marburg Lung Center (UGMLC), Institute for Lung Health (ILH), Cardio-Pulmonary Institute (CPI), Member of the German Center for Lung Research (DZL), Giessen, Germany
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2
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Sarubbi D, Sarubbi A, Strumia A, Pascarella G, Crucitti P, Longo F, Frasca L, Martuscelli M, Tomaselli E, Carassiti M, Agrò FE. I-gel® as airways management in a challenging adult tracheobronchial foreign body aspiration. Indian J Thorac Cardiovasc Surg 2024; 40:473-475. [PMID: 38919200 PMCID: PMC11194225 DOI: 10.1007/s12055-023-01676-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 12/22/2023] [Accepted: 12/22/2023] [Indexed: 06/27/2024] Open
Abstract
Tracheobronchial foreign body (TFB) aspiration is an uncommon but potentially life-threatening event. This case report discusses the successful extraction of a metallic screw aspirated by a 48-year-old woman with intellectual disability, using flexible bronchoscopy through the i-gel® laryngeal mask under general anesthesia. The i-gel® device proved effective in maintaining airway access and facilitating bronchoscopy, emphasizing its utility in challenging cases. The report underscores the significance of careful assessment, skillful intervention, and multidisciplinary teamwork in managing TFB aspirations, especially in uncooperative patients with comorbidities.
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Affiliation(s)
- Domenico Sarubbi
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Antonio Sarubbi
- Master’s Degree Program in Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Rome, Italy
- Thoracic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Alessandro Strumia
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
- Research Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Rome, Italy
| | - Giuseppe Pascarella
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Pierfilippo Crucitti
- Thoracic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Filippo Longo
- Thoracic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Luca Frasca
- Thoracic Surgery Department, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Matteo Martuscelli
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Eleonora Tomaselli
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
| | - Massimiliano Carassiti
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
- Research Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Rome, Italy
| | - Felice Eugenio Agrò
- Operative Research Unit of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128 Rome, Italy
- Research Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128 Rome, Italy
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3
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Zhang Y, Liang ZR, Xiao Y, Li YS, Fu BJ, Chu ZG. CT Characteristics and Clinical Findings of Bronchopneumonia Caused by Pepper Aspiration. Int J Gen Med 2024; 17:2757-2766. [PMID: 38895049 PMCID: PMC11184221 DOI: 10.2147/ijgm.s464076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/01/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose To explore the computed tomography (CT) features of bronchopneumonia caused by pepper aspiration to improve the diagnosis. Materials and Methods 28 adult patients diagnosed with obstructive pneumonia caused by pepper aspiration from January 2016 to September 2022 were enrolled. The CT characteristics of bronchial changes and pulmonary lesions caused by pepper were analyzed and summarized. Results Among 28 patients, the most common symptom was cough (26, 92.9%), followed by expectoration (23, 82.1%). Bronchoscopy revealed that peppers were mainly found in the bronchus of the right lower lobe (n = 18, 64.3%), followed by the bronchus of the left lower lobe (n = 5, 17.9%). In combination with bronchoscopy results, the pepper in the bronchus manifested as circular or V/U-shaped high-density, localized soft tissue, and flocculent opacification in 8 (28.6%), 16 (57.1%), and 3 (10.7%) cases on CT images, respectively. The bronchial wall around the pepper was thickened with localized occlusion (n = 19, 67.9%) and stenosis (n = 9, 32.1%). Regarding adjacent bronchi without peppers, extensive wall thickening with stenosis and/or occlusion was found in 23 (82.1%) cases. Distal pulmonary lesions frequently involved two or three segments (21, 75.0%) and mainly presented as patchy consolidation or atelectasis (24, 85.7%). Conclusion In combination to a history of eating peppers and clinical symptoms, bronchopneumonia caused by pepper should be highly suspected if U/V-shaped and annular high-density or localized soft tissue density is detected in the bronchi of the lower lobes, accompanied by extensive bronchial wall thickening, stenosis, or occlusion, and consolidation or atelectasis in multiple distal lung segments.
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Affiliation(s)
- Yi Zhang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Department of Radiology, Chongqing Jiangjin Second People’s Hospital, Chongqing Jiangjin Cancer Hospital, Chongqing, 402260, People’s Republic of China
| | - Zhang-Rui Liang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
- Department of Radiology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China
| | - Yang Xiao
- Department of Respiratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yi-Shi Li
- Department of Respiratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Bin-Jie Fu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Zhi-Gang Chu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
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4
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Hikiishi A, Nakai T, Matsui E, Yamane K, Sato K, Watanabe T, Asai K, Eguchi Y, Kawaguchi T. Successful Removal of a Foreign Body Located in the Peripheral Airway Using Flexible Bronchoscopy with Virtual Bronchoscopy Navigation. Intern Med 2024; 63:1439-1442. [PMID: 37839885 PMCID: PMC11157316 DOI: 10.2169/internalmedicine.2072-23] [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: 04/02/2023] [Accepted: 08/22/2023] [Indexed: 10/17/2023] Open
Abstract
A case in which a foreign body located in the peripheral airway of the lung was removed by flexible bronchoscopy using a virtual bronchoscopy navigation (VBN) system has been reported. The patient was a 60-year-old man. Chest radiography revealed an incidental foreign body in the left lower lung. Chest computed tomography with 1.0-mm slices was used to create a VBN system and confirm the foreign body in left B9biiαy, which was removed by flexible bronchoscopy. Thus, peripheral foreign bodies can be safely removed using flexible bronchoscopy by creating a VBN system in advance.
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Affiliation(s)
- Atsuhito Hikiishi
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
- Department of Respiratory Medicine, Bellland General Hospital, Japan
| | - Toshiyuki Nakai
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Erika Matsui
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kenshi Yamane
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kanako Sato
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Tetsuya Watanabe
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Kazuhisa Asai
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
| | - Yosuke Eguchi
- Department of Respiratory Medicine, Bellland General Hospital, Japan
| | - Tomoya Kawaguchi
- Department of Respiratory Medicine, Osaka Metropolitan University, Japan
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5
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Sun X, Ren J, Li B, Liu S, Zou J, Chen F, Wang H. Remove an Unusual Laryngeal Foreign Body with a Modified Endoscopic Injection Needle. Laryngoscope 2024; 134:2338-2340. [PMID: 37909667 DOI: 10.1002/lary.31121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023]
Abstract
Foreign body (FB) aspiration requiring prompt intervention to prevent severe complications. The endoscopic injection needle, commonly employed for intramucosal injections in the gastrointestinal tract and respiratory tract, while with no previous reports of used for FB extraction. Here we report a case of a pea impacted in the laryngeal ventricle of an adult patient, which became lodged in her right laryngeal ventricle. Conventional methods, such as flexible forceps and baskets, were deemed unsuitable for retrieving this fragile and mushy FB. Therefore, we introduce a novel technique using a modified endoscopic injection needle, which proved successful in removing the foreign body. Laryngoscope, 134:2338-2340, 2024.
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Affiliation(s)
- Xiaoru Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Ren
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Bo Li
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Shixi Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Zou
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Fei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Haiyang Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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6
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Georgakopoulou VE, Tarantinos K, Mermigkis D. Foreign Body in the Tracheobronchial Tree as a Cause of Hemoptysis in an Adult Without Risk Factors for Aspiration: A Case Report. Cureus 2024; 16:e57596. [PMID: 38707010 PMCID: PMC11069630 DOI: 10.7759/cureus.57596] [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: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Although aspiration of a foreign body into the trachea and bronchi can occur in all age groups, it is more common in infants and young children. Foreign bodies in the tracheobronchial tree are uncommon in adults and mainly present in patients with dysphagia and an altered level of consciousness. The identification of foreign bodies in the tracheobronchial tree is frequently overlooked or delayed, leading patients to present later with chronic symptoms and potential complications. These complications may include persistent coughing, wheezing, obstructive pneumonitis, bronchiectasis, and abscess formation secondary to recurrent pulmonary infections. This article aims to present the case of a 27-year-old patient without risk factors for aspiration who has experienced recurrent self-limiting hemoptysis episodes for five years. Bronchoscopy revealed a foreign body at the entrance to the middle lobe bronchus. The presence of a foreign body in the tracheobronchial tree should be considered in any patient with recurrent hemoptysis. Bronchoscopy leads to accurate diagnosis, treatment, and prevention of complications.
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7
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Sezer HF, Eliçora A, Topçu S. Foreign body aspirations with rigid bronchoscopy and esophagoscopy in children. TURK GOGUS KALP DAMAR CERRAHISI DERGISI 2024; 32:S55-S59. [PMID: 38584785 PMCID: PMC10995683 DOI: 10.5606/tgkdc.dergisi.2024.25688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/29/2023] [Indexed: 04/09/2024]
Abstract
Foreign body aspirations and esophageal foreign bodies are lifethreatening conditions. Sometimes they or their complications can cause severe morbidity and even mortality. Their exact incidence is unknown. Foreign body aspirations and esophageal foreign bodies are most commonly observed in the pediatric age group. While interventions are generally required for the removal of respiratory tract foreign bodies, the majority of esophageal foreign bodies come out spontaneously. Removal of foreign bodies that block the lumen of the organ to a great extent, react with the mucosa such as battery magnets, and can cause poisoning, sharp-edged objects, and swellable foreign bodies such as legumes, should be done acutely. In the removal of foreign bodies, endoscopic methods (flexible/rigid bronchoscope) are used in the respiratory system. Other methods used in esophageal foreign bodies are follow-up and pushing and pulling maneuvers with equipment, and at times, open surgical procedures can be applied. The success of the procedures is high, and patients can be discharged in the early postoperative period. Their incidence can be decreased by raising awareness on the subject, parents can be prevented from making wrong applications in these cases, and clinicians can keep these conditions in mind in differential diagnosis. In this article, the clinical features and diagnosis and treatment methods of foreign body aspiration and esophageal foreign bodies will be discussed separately.
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Affiliation(s)
- Hüseyin Fatih Sezer
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Aykut Eliçora
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Salih Topçu
- Department of Thoracic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
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8
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Costa ADS, Palomino ALM, Suzuki I, Garcia RG, Scordamaglio PR, Gregorio MG, Oliveira FND, Gonçalves MEP, Jacomelli M. Analysis of 108 flexible bronchoscopies for the removal of foreign bodies from the airways. EINSTEIN-SAO PAULO 2023; 21:eAO0391. [PMID: 38126657 PMCID: PMC10730257 DOI: 10.31744/einstein_journal/2023ao0391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 06/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To describe the clinical, bronchoscopic, diagnostic, and therapeutic aspects between children and adults. METHODS This retrospective study compared the clinical and bronchoscopic characteristics of adults and children who underwent bronchoscopy for suspected foreign body aspiration. Data on sex, outpatient or emergency origin, bronchoscopy results, characteristics of the aspirated foreign body, and complications were analyzed. RESULTS In total, 108 patients were included in the analysis, with foreign body aspiration diagnosed in 69% of patients (30 children and 44 adults). In 91% of patients, there was a clinical history suggestive of aspiration. The mean age of the adults was 65.89 (±19.75) years, and that of the children was 2.28 (±1.78) years. Most of the children were under 3 years of age (80%), while adults were mostly 70 years of age or older (54.5%). Emergency care was more common among children than adults. The most common foreign bodies found in both age groups were organic bodies, primarily seeds. The most frequent locations of foreign bodies were the lobar bronchi in adults and the main bronchi in children. Flexible bronchoscopy is the primary method for diagnosis and treatment. Transient hypoxemia occurred particularly frequently in children (5%). CONCLUSION Foreign body aspiration, particularly that involving seeds, is more common in the extremes of age. A clinical history suggestive of aspiration is crucial in determining the need for bronchoscopy, which should be performed as early as possible. Flexible bronchoscopy is an effective and safe diagnostic technique.
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Affiliation(s)
- Altair da Silva Costa
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
| | - Addy Lidvina Mejia Palomino
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
| | - Iunis Suzuki
- A.C.Camargo Cancer CenterSão PauloSPBrazil
A.C.Camargo Cancer Center
,
São Paulo
,
SP
,
Brazil
.
| | - Rodrigo Gobbo Garcia
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
| | - Paulo Rogerio Scordamaglio
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
| | - Marcelo Gervilla Gregorio
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
| | | | | | - Marcia Jacomelli
- Hospital Israelita Albert EinsteinSão PauloSPBrazil
Hospital Israelita Albert Einstein
,
São Paulo
,
SP
,
Brazil
.
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9
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Himeji D, Shiiba R, Tanaka GI, Shimonodan H, Kojima K. Broken Tip of a Disposable Saliva Ejector as a Bronchial Foreign Body in a Patient With Severe Physical and Intellectual Disabilities. Cureus 2023; 15:e50854. [PMID: 38249272 PMCID: PMC10798818 DOI: 10.7759/cureus.50854] [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: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Oral care for patients with severe physical and intellectual disabilities is important to prevent the development of systemic diseases and maintain or improve their health. Foreign bodies accidentally aspirated into the respiratory tract can cause critical problems. To our knowledge, this is the first case report of aspiration of a broken tip of a disposable saliva ejector in a patient with severe physical and intellectual disabilities. The patient's strong bite broke off the ejector's tip during oral care. The foreign body was removed by flexible bronchoscopy without any complications. Such cases are sometimes asymptomatic or mildly symptomatic; thus, learning how to appropriately respond is essential for caregivers and family doctors. In addition, this device is widely used in clinical practice, and such risks should be widely known. Moreover, manufacturers should develop more robust equipment for oral care.
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Affiliation(s)
- Daisuke Himeji
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN
| | - Ritsuya Shiiba
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN
| | - Gen-Ichi Tanaka
- Department of Internal Medicine, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN
| | - Hidemi Shimonodan
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN
| | - Kotaro Kojima
- Department of Pediatrics, Miyazaki Prefectural Miyazaki Hospital, Miyazaki, JPN
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10
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Toyoshima H, Nigi A, Tanaka H, Kobayashi C, Uraki J, Tanigawa M. Magnesium Oxide as an Unexpected Bronchial Foreign Body in an Elderly Patient. Intern Med 2023; 62:3511-3514. [PMID: 37062744 PMCID: PMC10749810 DOI: 10.2169/internalmedicine.1618-23] [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: 01/14/2023] [Accepted: 03/05/2023] [Indexed: 04/18/2023] Open
Abstract
As cases of magnesium oxide pill aspiration are rare, the associated airway proinflammatory properties and appropriate analytic strategies remain unclear. An 81-year-old woman presenting with dyspnea was diagnosed with magnesium oxide pill aspiration. Computed tomography, a "mixing test" with levodopa, and a magnesium content analysis revealed a similar density between the foreign body and her prescribed magnesium oxide pill. The patient recovered without airway complications after foreign body removal. Clinicians should be aware of magnesium oxide tablets as potential bronchial foreign bodies in elderly patients because they may not dissolve without exposure to gastric juices.
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Affiliation(s)
- Hirokazu Toyoshima
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, Japan
| | - Akina Nigi
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Japan
| | - Hiroyuki Tanaka
- Department of Infectious Diseases, Japanese Red Cross Ise Hospital, Japan
| | - Chiaki Kobayashi
- Department of Medical Technology, Japanese Red Cross Ise Hospital, Japan
| | - Junji Uraki
- Department of Radiology, Japanese Red Cross Ise Hospital, Japan
| | - Motoaki Tanigawa
- Department of Respiratory Medicine, Japanese Red Cross Ise Hospital, Japan
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11
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Broadhead A, Schwartz CM, Idicula WK. Removal of airway foreign bodies complicated by an unstable cervical spine fracture. Int J Pediatr Otorhinolaryngol 2023; 174:111742. [PMID: 37793319 DOI: 10.1016/j.ijporl.2023.111742] [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: 04/30/2023] [Revised: 09/04/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
Aspiration of foreign bodies is common and among the leading causes of accidental death in children. When detected promptly, an experienced physician can successfully manage foreign bodies of the airway. However, uncommon objects and physical trauma can complicate their removal. Inhalation of organic and inorganic foreign bodies of all types is well documented, but glass in the airway is an unusual and difficult problem. Further, airway foreign bodies in conjunction with an unstable cervical spine are rare. Polytrauma tends to complicate any case. We present a case illustrating both circumstances: tempered automotive glass in the airway of a child with an unstable cervical spine fracture.
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Affiliation(s)
- Austin Broadhead
- The Texas Tech University Health Sciences Center School of Medicine, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
| | - Cynthia M Schwartz
- The Texas Tech University Health Sciences Center Department of Otolaryngology, TTUHSC Department of Otolaryngology, 3601 4th Street, STOP 8315, Lubbock, TX, 79430-8315, USA.
| | - Winslo K Idicula
- The Texas Tech University Health Sciences Center Department of Otolaryngology, TTUHSC Department of Otolaryngology, 3601 4th Street, STOP 8315, Lubbock, TX, 79430-8315, USA.
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12
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Das P, Gupta P, Deepak D. Cytological Diagnosis of Pulmonary Hydatid disease by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Cyst Fluid. J Bronchology Interv Pulmonol 2023; 30:392-397. [PMID: 37254236 DOI: 10.1097/lbr.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023]
Affiliation(s)
- Pinakjyoti Das
- Pathology Department, ABVIMS and Dr RML Hospital, New Delhi
| | - Prajwala Gupta
- Pathology Department, ABVIMS and Dr RML Hospital, New Delhi
| | - Desh Deepak
- Respiratory Medicine Department ABVIMS and Dr RML Hospital, New Delhi
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Wu Y, Zhang X, Lin Z, Ding C, Wu Y, Chen Y, Wang D, Yi X, Chen F. Changes in the global burden of foreign body aspiration among under-5 children from 1990 to 2019. Front Pediatr 2023; 11:1235308. [PMID: 37727616 PMCID: PMC10506258 DOI: 10.3389/fped.2023.1235308] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Background To evaluate the changes in the global burden of foreign body aspiration (FBA) among children under 5 years old at regional, age, sex, and socio-demographic index (SDI) levels between 1990 and 2019. Methods Data on FBA was derived from the Global Burden of Disease (GBD) Study 2019 database on pulmonary aspiration and foreign body in airway. The means and 95% uncertainty intervals (UIs) were calculated for incidence, and disability-adjusted life-years (DALYs). The temporal trends were represented by estimated annual percentage change (EAPC) using Joinpoint regression. Results Globally, FBA caused 109.6 (95% UI: 69.5, 175.7) per 100,000 incidence and 317.9 (95% UI: 270.7, 372.4) per 100,000 DALYs under 5 years old in 2019. Many European countries (such as Italy, Netherlands, Iceland, etc.) showed a high incidence rate, but did not cause a large disease burden (DALYs all less than 200 per 100,000). Compared to 1990, although a decrease in both incidence and DALYs occurred in 2019, the Joinpoint regression showed an increasing trend in incidence rate from 2014 to 2019 [APC: both (2.10), female (2.25), male (1.98), P < 0.05)], especially China, Netherlands, and Malta. Despite the lower incidence rate in early neonatal group and middle SDI areas, they instead resulted in higher DALYs than other age groups and areas. Conclusion Although declines occurred in incidence and DALYs of FBA among children under 5 years of age from 1990 to 2014, an upward trend began to emerge from 2014 to 2019. The incidence and DALY rates were correlated with age and SDI. Increased efforts are needed to improve the necessary monitoring and reporting systems, hazard assessment, and public education activities.
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Affiliation(s)
- Yuying Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xin Zhang
- Fujian Branch of Shanghai Children’s Medical Center, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children’s Hospital, Fujian Medical University, Fuzhou, China
| | - Zaigang Lin
- Laboratory Animal Center, Fujian Medical University, Fuzhou, China
| | - Chenyu Ding
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Yuxuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yue Chen
- Department of Neurosurgery, Neurosurgery Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Desheng Wang
- Department of Otolaryngology Head and Neck Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xuehan Yi
- Department of Otolaryngology Head and Neck Surgery, Fujian Medical University Union Hospital, Fuzhou, China
| | - Fa Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
- Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China
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14
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Ekim A, Altun A. Foreign body aspirations in childhood: A retrospective review. J Pediatr Nurs 2023; 72:e174-e178. [PMID: 37355460 DOI: 10.1016/j.pedn.2023.06.025] [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: 02/05/2023] [Revised: 06/15/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE The aim of this study was to examine the childhood-age foreign body aspiration (FBA) retrospectively by focusing on symptoms, types, home interventions, hospitalization and complications. METHOD All patients between 0-18 years admitted to pediatric surgical clinic and diagnosed with FBA were examined retrospectively from January 2021 to January 2022. RESULTS The study group consisted of 163 patients and their mean age was 17.8±12.7 months (1 months to 6 years). FBA events included aspiration of food (78%), coins (10%), batteries (3.7%), parts of toys (4%), buttons (2.4%) and other (2%). First aid treatment to children was performed at home by mothers (61%). Types of first aid treatment performed by mothers included tapping the back (31%); cleaning inside the mouth (24%); trying to remove the foreign body with fingers (12%), pushing the foreign body forward (5.9%) and forcing the child to vomit (9.5%) respectively. CONCLUSIONS FBA is a potential life-threatening health problem during childhood. When the age of majority of patients being under one year old and prevalence of food in FBA types are taken into consideration, safe-feeding practices of mothers, feeding position and training about the safe-environment are the basic steps of prevention strategies. PRACTICE IMPLICATIONS One of the most useful ways of preventing FBA cases is to provide planned and continuing education to parents, care givers and all the individuals responsible for the care of the child in order to increase their knowledge and practice levels.
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Affiliation(s)
- Ayfer Ekim
- Faculty of Health Sciences, Department of Pediatric Nursing, Istanbul Arel University, Istanbul, Turkey..
| | - Aslıhan Altun
- Graduate Education Institute, Istanbul Arel University, Istanbul, Turkey
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15
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Wang Y, Zhou Y, Pan F, Wang Y. An unusual presentation of necrotizing pneumonia caused by foreign body retention in a 20-month-old child: A case report and literature review. Front Pediatr 2023; 11:1203103. [PMID: 37397148 PMCID: PMC10311010 DOI: 10.3389/fped.2023.1203103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 05/31/2023] [Indexed: 07/04/2023] Open
Abstract
Necrotizing pneumonia (NP) is a rare but serious complication that occurs after foreign body retention. We report a case of severe NP in an infant caused by foreign body retention in the airway with no choking history. After a timely tracheoscopy and effective antibiotic treatment, her initial clinical symptoms were alleviated. However, she subsequently exhibited pulmonary manifestations of necrotizing pneumonia. To reduce the risk of NP from foreign body aspiration, for patients with airway obstruction and asymmetrical opacity of both lungs, timely diagnostic bronchoscopic evaluation is essential.
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Affiliation(s)
- Yuqi Wang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yunlian Zhou
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Feng Pan
- Department of Pediatrics, Xuancheng People’s Hospital, Xuancheng, China
| | - Yingshuo Wang
- Department of Pulmonology, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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16
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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.
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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
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17
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Westhoff J, Alexanidou E, Hofmann J, de Laffolie J, Naehrlich L. Be flexible when unscrewing: Screw aspiration in a 15-year-old girl. Pediatr Pulmonol 2023; 58:1266-1268. [PMID: 36606690 DOI: 10.1002/ppul.26307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Affiliation(s)
- J Westhoff
- Department of Pediatrics, Pediatric Pulmonology, Justus-Liebig-University Giessen, Giessen, Germany
| | - E Alexanidou
- Department of Pediatrics, Pediatric Gastroenterology, Justus-Liebig-University Giessen, Giessen, Germany
| | - J Hofmann
- Department of Anesthesiology, Intensive Care Medicine, and Pain Management, Justus-Liebig-University Giessen, Giessen, Germany
| | - J de Laffolie
- Department of Pediatrics, Pediatric Gastroenterology, Justus-Liebig-University Giessen, Giessen, Germany
| | - L Naehrlich
- Department of Pediatrics, Pediatric Pulmonology, Justus-Liebig-University Giessen, Giessen, Germany
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18
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Bosnali O, Moralioğlu S, Celayir A. Rare laryngotracheobronchial anomalies in children: a retrospective study of 249 bronchoscopic cases in a single center. Hippokratia 2023; 27:59-63. [PMID: 39056096 PMCID: PMC11268310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Background Laryngotracheobronchial anomalies in children are rare, and their clinical manifestations are diverse. In this study, we report the clinical aspects and prevalence rates of tracheal bronchus (TB) and congenital subglottic stenosis (CSS) in a select group of patients at our institution and briefly review and discuss the literature to draw attention to these rare anomalies. Case series We retrospectively reviewed the clinical records of 249 children for whom senior surgeons performed rigid bronchoscopy for suspected or confirmed food choking or foreign body aspiration in children between August 2013 and January 2020. Bronchoscopic findings and demographics of the patients with laryngotracheobronchial anomalies were documented. Four among the 249 patients (1.6 %) had right-sided TB (two males aged 24 and 42 months and two females aged 14 and 60 months), while three (1.2 %) had grade 1 CSS (one male aged eight months and two females aged 11 and 13 months). There was no previous history of endotracheal intubation for any subglottic stenosis (SS), though all three patients were admitted with sudden onset of respiratory difficulty. One of the TB cases had congenital cardiac anomalies, and two were symptomatic before their admission to the emergency department. Conclusions The prevalence of CSS and TB in the healthy population is low. Physicians dealing with the pediatric airways should consider such anomalies for prompt diagnosis, proper instrumentation, management, and follow-up of these cases. Our data also correlate with previous data, indicating that these anomalies' prevalence rates have not increased during the last few decades. HIPPOKRATIA 2023, 27(2):59-63.
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Affiliation(s)
- O Bosnali
- Department of the Pediatric Surgery, Zeynep Kamil Maternity and Children's Diseases, Health Training and Research Center, University of Health Sciences Turkey, Istanbul, Turkey
| | - S Moralioğlu
- Department of the Pediatric Surgery, Zeynep Kamil Maternity and Children's Diseases, Health Training and Research Center, University of Health Sciences Turkey, Istanbul, Turkey
| | - A Celayir
- Department of the Pediatric Surgery, Zeynep Kamil Maternity and Children's Diseases, Health Training and Research Center, University of Health Sciences Turkey, Istanbul, Turkey
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Bar Giora Y, Weingram T, Altabet L, Yair N, Kachtan I, Bar Am Y. Tooth aspiration in two cats following maxillofacial trauma. JFMS Open Rep 2022; 8:20551169221125403. [PMID: 36249673 PMCID: PMC9554134 DOI: 10.1177/20551169221125403] [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] [Indexed: 11/06/2022] Open
Abstract
Case series summary Tooth aspiration is a rare occurrence in human medicine, and even more so in veterinary medicine. This report describes two cats that aspirated a tooth (one canine tooth and one premolar tooth) following maxillofacial trauma. One cat presented with dyspnoea, while the other showed no respiratory clinical signs. In both cases diagnosis was reached by obtaining routine thoracic radiographs, and successful retrieval of the teeth was achieved by bronchoscopy. Both cats recovered uneventfully. Relevance and novel information To our knowledge, this is the first report in the veterinary literature of tooth aspiration into the tracheobronchial tree following maxillofacial trauma. The scope of this case series is to raise awareness that tooth aspiration can occur following maxillofacial trauma and has the potential for serious complications if not diagnosed and treated promptly. Therefore, an oral examination must be performed in every maxillofacial trauma patient and missing teeth should be accounted for, even when respiratory clinical signs are not detected.
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Affiliation(s)
- Yael Bar Giora
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Allone Abba, Israel
| | | | - Lior Altabet
- Vetoscope – Mobile Veterinary Endoscopy, Rishon Lezion, Israel
| | - Nadav Yair
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Allone Abba, Israel
| | - Ido Kachtan
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Allone Abba, Israel
| | - Yoav Bar Am
- Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Allone Abba, Israel,Yoav Bar Am DVM, Dip AVDC, Dip EVDC, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Derech Hamaccabim 70, Rishon Lezion, Israel
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20
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Risal R, Aung HM, Jahir T, Subedi KR, Hossain S, Thida AM, Schmidt M, Enriquez D. Endobronchial Foreign Bodies Presenting as Intermittent Chest Pain and Productive Cough. Cureus 2022; 14:e29599. [DOI: 10.7759/cureus.29599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
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21
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Awonusi O, Halum S. Airway foreign body retrieval in a tracheostomy-dependent patient with severe laryngeal stenosis. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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22
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Weinberg L, Shearer N, Duong DMC, Neal-Williams T. Airway foreign body during bronchoscopy: an unexpected complication when using a dual-axis swivel adapter. BMJ Case Rep 2022; 15:e250530. [PMID: 35896304 PMCID: PMC9335022 DOI: 10.1136/bcr-2022-250530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Laurence Weinberg
- Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
- Department of Critical Care, The University of Melbourne - Parkville Campus, Parkville, Victoria, Australia
| | - Nicholas Shearer
- Department of Anaesthesia, Northern Hospital Epping, Epping, Victoria, Australia
| | | | - Tom Neal-Williams
- Department of Anaesthesia, Northern Hospital Epping, Epping, Victoria, Australia
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23
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Li L, Li MJ, Sun L, Jiang YL, Zhu J. Neglected Foreign Body Aspiration Mimicking Lung Cancer Recurrence. Healthc Policy 2022; 15:491-496. [PMID: 35321269 PMCID: PMC8935719 DOI: 10.2147/rmhp.s361081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/08/2022] [Indexed: 12/03/2022] Open
Abstract
Foreign body aspiration (FBA) occurs less frequently in adults than in children. Case reports of FBAs occurring in adults after lung surgery are not found in the literature, and this particular condition is often misdiagnosed. We report a case in which the patient was diagnosed after various events. A 56-year-old female patient had undergone robotic-assisted resection of the right upper lobe. The patient recovered well after the operation, with a slight irritant dry cough. Chest computed tomography (CT) examination of the patient showed no obvious abnormality early postoperatively. However, she developed intermittent cough and hemoptysis at six months. Repeat chest CT showed a soft tissue shadow near the bronchus in the lower lobe of the right lung. Cancer recurrence, surgery-related foreign body residue, lymphoid reactive hyperplasia, or other reasons was considered. Further examination revealed a piece of watermelon seed shell blocking the bronchial opening of the lower lung. This case highlights the importance of medical history, careful physical examination and fiberoptic bronchoscopic examination after lung cancer surgery due to lung cancer recurrence risk or FBA.
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Affiliation(s)
- Lei Li
- Department of the First Surgery, Wuhan Jin-Yin-Tan Hospital, Wuhan, 430011, People’s Republic of China
| | - Meng-Jie Li
- Department of Respiratory Oncology, Renmin Hospital of Qingxian, Cangzhou, 062650, People’s Republic of China
| | - Liu Sun
- Department of Otolaryngology-Head and Neck Surgery, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, 430070, People’s Republic of China
| | - Yuan-Liang Jiang
- Department of Radiology, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, 430070, People’s Republic of China
| | - Jian Zhu
- Department of Thoracic Cardiovascular Surgery, General Hospital of Central Theater Command of the People’s Liberation Army, Wuhan, 430070, People’s Republic of China
- Correspondence: Jian Zhu; Yuan-Liang Jiang, General Hospital of Central Theater Command of the People’s Liberation Army, 627#, Wuluo Road, Wuchangqu, Wuhan, Hubei, 430070, People’s Republic of China, Tel +86-13871166489, Fax +86-27-50772388, Email ;
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24
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Ding L, Su S, Chen C, Yao H, Xiao L. Tracheobronchial Foreign Bodies in Children: Experience From 1,328 Patients in China. Front Pediatr 2022; 10:873182. [PMID: 35722476 PMCID: PMC9199421 DOI: 10.3389/fped.2022.873182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/04/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze the clinical characteristics of tracheobronchial foreign body (FB) cases in a pediatric Chinese population. METHODS The clinical data of pediatric patients aged 0-18 years old diagnosed with a tracheobronchial FB in the Children's Hospital of Chongqing Medical University between September 2018 and August 2021 were analyzed retrospectively. RESULTS Among 1,328 included cases, 92.09% of patients were <3 years old, the male to female ratio was 1.86:1. The prevalence of tracheobronchial FB was similar between patients living in rural and urban areas and tracheobronchial FBs were more common in winter. The most common presenting symptoms were cough and wheezing. The most common CT findings was local obstruction or tracheobronchial narrowing, followed by obstructive emphysema of lung and pneumonia. The 11.3% of cases that did not report FB aspiration on admission had a longer time to hospital admission and longer hospitalization time than cases reporting FB aspiration (P < 0.05). The most common FB type was nuts (81.17%). FBs were more frequently located in the right bronchus, and 64 (4.82%) cases involved multiple FBs. FBs were expelled by coughing in only 4.07% of cases. For the other cases, FB removal by first bronchoscopy in our hospital was successful and complete in 96.86% of cases. 1.51% of patients had hypoxic ischemic encephalopathy (HIE) and the location of FBs was a possible risk factor for HIE (P < 0.05). CONCLUSIONS Tracheobronchial FBs occurred most commonly in children <3 years old. If asphyxia occurs in children which FBs aspirated, emergency treatment is needed to reduce the occurrence of HIE. Rigid bronchoscopy remains the first-line method for FB removal in children.
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Affiliation(s)
- Ling Ding
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
| | - Shuping Su
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
| | - Cheng Chen
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
| | - Hongbing Yao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
| | - Ling Xiao
- Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.,National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China.,Chongqing Key Laboratory of Pediatrics, Chongqing, China.,Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, China
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