Ponad 7000 publikacji medycznych!
Statystyki za 2021 rok:
odsłony: 8 805 378
Artykuły w Czytelni Medycznej o SARS-CoV-2/Covid-19

Poniżej zamieściliśmy fragment artykułu. Informacja nt. dostępu do pełnej treści artykułu tutaj
© Borgis - New Medicine 4/2012, s. 105-107
*Teresa Ryczer, Lidia Zawadzka-Głos, Mieczysław Chmielik, Patrycja Szczupak
The clinical characteristics and radiographic findings in patients with foreign body aspiration
Department of Pediatric Otolaryngology, Medical University of Warsaw, Poland
Head of Department: Lidia Zawadzka-Głos, MD, PhD
Summary
Introduction. Foreign body (FB) aspiration can lead to acute, life-threatening airway obstruction. Positive history of FB aspiration, clinical signs and symptoms with radiographic findings in a patient with suspected FB aspiration can help us to form diagnosis.
Material and methods. The retrospective analysis of clinical data of 67 patients, suspected of FB aspiration, that were hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from January 2008 to January 2012, was performed. We analyzed demographic and clinical characteristics, type of X-ray, radiographic findings, type and location of FB in airways.
Conclusions. The positive history of FB aspiration is an indication to perform bronchoscopy. In every case when FB aspiration is suspected, bronchoscopy should be performed. Anteroposterior or lateral decubitus chest X-ray findings can be helpful in the early stage of forming diagnosis. However, the negative chest X-ray does not exclude FB in respiratory tract. Anteroposterior chest X-ray has low sensitivity in patients with radiolucent airway FB.
INTRODUCTION
Foreign body (FB) aspiration can be a life-threatening situation or can lead to chronic, non-specific symptoms (4). Foreign body inhalation is a potentially life-threatening emergency and is the commonest cause of accidental death in children under one year old (15).
MATERIAL AND METHODS
We analyzed clinical data of 67 patients, suspected of FB aspiration, that were hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from January 2008 to January 2012. Demographic and clinical characteristics, type of X-ray, radiographic findings, type and location of FB in airways were taken into account.
RESULTS
In our study there was male predominance (boys n = 45, girls n = 22). The median age was 2 years (the average age was 3,24 years, the age ranged from 10 months to 16 years).
History of FB aspiration was present in 89% of patients (n = 60). In all patients (n = 67) with suspected FB aspiration bronchoscopy was performed. Positive bronchoscopic findings were present in 84% of cases (n = 56).
The most common clinical symptoms were cough (n = 26, dyspnea (n = 18), wheezing (n = 12), and fever (n = 80). The findings on chest auscultation stated by pediatrician were in most commonly asymmetric breath sounds (n = 25), wheezes (n = 23), ronchi (n = 13).
Posteroanterior chest X-ray was done in 80.6% of patients, whereas lateral decubitus chest X-ray in 30.1% of cases. Among patients that underwent lateral decubitus chest X-ray, most of them (85%) had previously PA chest X-ray. The most common radiological findings were emphysema (35%), mediastinal shift (14%), athelectasis (12%) and alveolar consolidations (10.5%). The normal chest X-ray was reported in 18% of patients. The sensitivity of PA chest X-ray was 67%, whereas the specificity was 46%. The sensitivity and specificity of lateral decubitus chest X-ray was subsequently 75% and 100%.
Right bronchus (50.8%, n = 29) was the most frequent location of extracted FB. Other locations were left bronchus (30%, n = 17), right and left bronchus (n = 3), lobar bronchi (n = 3), right/left bronchus and trachea (n = 2), trachea (n = 1).
Almost all of FBs were radiolucent in nature (n = 56). There was one radio-opaque FB which was a pin. The most common extracted FB was peanut (n = 43). Among other Fbs were a piece of apple (n = 4), a piece of plastic (n = 2), and a toy block, rubber, pin, whistle, pumpkin seed, a piece of bark, bead (n = 1).
DISCUSSION
The diagnosis of a bronchial FB can be accurately made in 83.5% of the cases in the presence of a positive history of possible aspiration, significant physical findings and supportive roentgenographic evidence (8). However, tracheobronchial foreign bodies should be strong suspected in pediatric patients who present with suggestive history of aspiration, even when physical and radiographic evidence is absent (1, 3).
In our study there was male predominance (boys n = 45, girls n = 22), which correlates with literature data (3, 12).
The highest incidence of FB in respiratory tract occurs between 1 and 3 years, the peak incidence of FB aspiration in children is between the ages of 1 and 2 years. It is the result of their increasing activity and curiosity, lessening of close parental supervision and in that period of life children have tendency to put objects in their mouths (3, 4, 6, 10-12, 14, 15). The median age in our group of patients was 2 years.

Powyżej zamieściliśmy fragment artykułu, do którego możesz uzyskać pełny dostęp.
Mam kod dostępu
  • Aby uzyskać płatny dostęp do pełnej treści powyższego artykułu albo wszystkich artykułów (w zależności od wybranej opcji), należy wprowadzić kod.
  • Wprowadzając kod, akceptują Państwo treść Regulaminu oraz potwierdzają zapoznanie się z nim.
  • Aby kupić kod proszę skorzystać z jednej z poniższych opcji.

Opcja #1

19

Wybieram
  • dostęp do tego artykułu
  • dostęp na 7 dni

uzyskany kod musi być wprowadzony na stronie artykułu, do którego został wykupiony

Opcja #2

49

Wybieram
  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 30 dni
  • najpopularniejsza opcja

Opcja #3

119

Wybieram
  • dostęp do tego i pozostałych ponad 7000 artykułów
  • dostęp na 90 dni
  • oszczędzasz 28 zł
Piśmiennictwo
1. Shivakumar AM, Naik AS, Prashanth KB et al.: Tracheobronchial foreign bodies. Indian J Pediatr 2003; 70(10): 793-797. 2. Brkić F, Delibegović-Dedić S, Hajdarović D: Bronchoscopic removal of foreign bodies from children in Bosnia and Herzegovina: experience with 230 patients. Int J Pediatr Otorhinolaryngol 2001; 60(3): 193-196. 3. Brkić F, Umihanic Š: Tracheobronchial foreign bodies in children. Experience at ORL clinic Tuzla, 1954-2004. Int J Pediatr Otorhinolaryngol 2007; 71(6): 909-915. 4. Cassol V, Pereira AM, Zorzela LM et al.: Foreign body in children’s airways. J Pneumol 2003; 29(3), (Sao Paulo maio/jun). 5. Bloom DC, Christenson TE, Manning SC et al.: Plastic laryngeal foreign bodies in children: A diagnostic challenge. Int J Pediatr Otorhinolaryngol 2005; 69(5): 657-662. 6. Sahni JK, Mathur NN, Kansal Y, Rana I: Bronchial foreign body presenting as an accidental radiological finding. Int J Pediatr Otorhinolaryngol 2002; 64(3): 229-232. 7. Strome M: Tracheobronchial foreign bodies: an updated approach. Ann Otol Rhinol Laryngol 1977; 86(5 Pt 1): 649-654. 8. Wiseman NE: The diagnosis of foreign body aspiration in childhood. J Pediatr Surg 1984; 19(5): 531-535. 9. Ikeda M, Himi K, Yamauchi Y et al.: Use of digital subtraction fluoroscopy to diagnose radiolucent aspirated foreign bodies in infants and children. Int J Pediatr Otorhinolaryngol 2001; 61(3): 233-242. 10. Singhal P, Sonkhya N, Srivastava SP: Migrating foreign body in the bronchus. Int J Pediatr Otorhinolaryngol 2003; 67(10): 1123-1126. 11. Daines CL, Wood RE, Boesch RP: Foreign body aspiration: An important etiology of respiratory symptoms in children. J Allergy Clin Immunol 2008;121(5): 1297-1298. 12. Tan HKK, Brown K, McGill T et al.: Airway foreign bodies (FB): a 10-year review. Int J Pediatr Otorhinolaryngol 2000; 56(2): 91-99. 13. Johnson DG: Foreign Bodies in the Pediatric Patient, Curr Probl Surg 1998; 35(4): 271-379. 14. Foltran F, Ballali S, Passali FM et al.: Foreign bodies in the airways: A meta-analysis of published papers. Int J Pediatr Otorhinolaryngol 2012; 76 (Suppl. 1): S12-19. 15. Mani N, Soma M, Massey S et al.: Removal of inhaled foreign bodies – middle of the night or the next morning? Int J Pediatr Otorhinolaryngol 2009; 73(8): 1085-1089. 16. Skoulakis CE, Doxas PG, Papadakis ChE et al.: Bronchoscopy for foreign body removal in children. A review and analysis of 210 cases, Int J Pediatr Otorhinolaryngol 2000; 53(2): 143-148.
otrzymano: 2012-10-08
zaakceptowano do druku: 2012-10-31

Adres do korespondencji:
*Teresa Ryczer
Department of Pediatric Otolaryngology Medical University of Warsaw
24 Marszałkowska St., 00-576 Warsaw
tel./fax: +48 (22) 628-05-84
e-mail: laryngologia@litewska.edu.pl

New Medicine 4/2012
Strona internetowa czasopisma New Medicine