BACKGROUND: Our objective was to assess types, presentation, duration of symptoms and usefulness of rigid bronchoscopy for diagnosis and treatment of bronchial foreign body (FB) in children. [ncbi.nlm.nih.gov]

Conclusion: High index of suspicion should be kept for bronchial FB in children who present with suggestive history of FB ingestion even with normal physical and radiological evaluation. [afrjpaedsurg.org]

• Fever

  The advent of flexible endoscopy revolutionized the care of these patients. 6 Recent studies have postulated flexible bronchoscopy has higher success rate than rigid bronchoscopy. 7 The common symptoms of FB aspirations are cough, fever, hemoptysis and [apicareonline.com]

  He had no history of fever, no cold and no history of vomiting or choking. Bowel and bladder habits were normal. He had no significant past medical history. The patient had normal birth history, normal growth, and immunization was up to date. [f1000research.com]

  Symptoms may include persistent wheeze, cough, fever or dyspnoea not otherwise explained. Recurrent or persistent pneumonia may be the presenting feature. The child may be asymptomatic after the initial event. [rch.org.au]

  The major presenting symptoms were cough, fever, breathlessness [Table 5]. Common signs were tachypnoea, unilateral diminished breath sounds and rhochi/crepitations. [Table 5]. The commonest radiological feature was obstructive emphysema [Table 6]. [ijaweb.org]

  […] sedative use Presentation Symptoms severe obstruction may present with respiratory distress aphonia cyanosis loss of consciousness and death in quick succession partial, long-term obstruction may present with less severe respiratory symptoms dysphagia fever [medbullets.com]

• Cough

  Case Presentation A 78 years old lady presented to the emergency room with a three-month history of dry cough. [austinpublishinggroup.com]

  A total of 87% of patients had a definite history of aspiration, with cough (69.5%), and unilateral decreased air entry (91.3%) being the most common symptom and clinical sign, respectively. [ncbi.nlm.nih.gov]

  Case presentation A one year boy with a history of cough and noisy breathing for 2 days was brought to Renmin Hospital with a sudden onset of difficulty in breathing and severe cough for 5 hours. [f1000research.com]

  An eight-year-old child presented with a history of recurrent cough for 3 days. Rigid bronchoscopy under general anesthesia revealed plastic bead occupying right main bronchus. [ijccm.org]

• Stridor

  After the bronchoscopy, the child is observed in a anaesthesia recovery room for stridor, respiratory distress or other signs suggestive of subglottic edema, damaged teeth, haemorrhage, bronchospasm and airway perforation. [ijaweb.org]

  He had no nasal congestion, rhinorrhea, stridor, or previous history of difficulty breathing. Figure 1. [consultant360.com]

  In patients with stridor, a soft-tissue lateral film of the neck may be useful. Aspirated foreign body (backing to an earring) lodged in the right main stem bronchus. [emedicine.medscape.com]

  (especially nuts), teeth, dental devices and medical instruments Some nuts, such as peanuts, have an oil that leads to inflammation and edema making them more difficult to expel Clinical Findings Many go undiscovered delaying diagnosis Cough Wheeze Stridor [learningradiology.com]

  LARYNGEAL FOREIGN BODY SYMPTOMS  Croup(laryngotracheobronchitis)  Stridor(abnormal, high-pitched, musical breathing sound)  Cough  Hoarseness  Dyspnoea  Odynophagia(painful swallowing)  Aphonia 14. [slideshare.net]

• Dyspnea

  The first published case of endoscopic extraction occurred on 30th March 1897, when a 63-year-old German farmer experienced dyspnea, cough and hemoptysis after aspirating a pork bone (11 mm long and 3 mm wide). [archbronconeumol.org]

  […] advent of flexible endoscopy revolutionized the care of these patients. 6 Recent studies have postulated flexible bronchoscopy has higher success rate than rigid bronchoscopy. 7 The common symptoms of FB aspirations are cough, fever, hemoptysis and dyspnea [apicareonline.com]

  Children may otherwise present with cough, dyspnea, or irritability 2,6. Most (70-90%) foreign bodies are organic, most commonly seeds and nuts. Inorganic foreign bodies vary dramatically and can include teeth, coins, pins, pens/crayons, etc. [radiopaedia.org]

  As there was history of sudden onset of difficulty in breathing, severe cough, inspiratory dyspnea and decrease air entry on the right lung, we planned for a CT scan of the chest. [f1000research.com]

  […] especially nuts), teeth, dental devices and medical instruments Some nuts, such as peanuts, have an oil that leads to inflammation and edema making them more difficult to expel Clinical Findings Many go undiscovered delaying diagnosis Cough Wheeze Stridor Dyspnea [learningradiology.com]

• Hemoptysis

  The advent of flexible endoscopy revolutionized the care of these patients. 6 Recent studies have postulated flexible bronchoscopy has higher success rate than rigid bronchoscopy. 7 The common symptoms of FB aspirations are cough, fever, hemoptysis and [apicareonline.com]

  FBA may be in place for months before being diagnosed, and can produce complications like infections (pneumonia and abscess), chronic coughing, hemoptysis, bronchial stenosis and atelectasis. [radiopaedia.org]

  The first published case of endoscopic extraction occurred on 30th March 1897, when a 63-year-old German farmer experienced dyspnea, cough and hemoptysis after aspirating a pork bone (11 mm long and 3 mm wide). [archbronconeumol.org]

  […] use Presentation Symptoms severe obstruction may present with respiratory distress aphonia cyanosis loss of consciousness and death in quick succession partial, long-term obstruction may present with less severe respiratory symptoms dysphagia fever hemoptysis [medbullets.com]

  Persistent febrile illness Chronic cough Recurrent pneumonia Recurrent / persistent “croup” Poorly controlled “asthma” Lung abscess Hemoptysis Progressive respiratory distress Death Delayed diagnosis of an aspirated foreign body is associated with increased [pedemmorsels.com]

• Dry Cough

  Case Presentation A 78 years old lady presented to the emergency room with a three-month history of dry cough. [austinpublishinggroup.com]

  Patient after discharge developed dry cough which gradually worsened in due course of time in spite of taking medications. [laryngologyandvoice.org]

  Trachea – similar to larynx in presentation, but can have biphasic stridor, dry cough. Often appear uncomfortable or scared. Bronchus – 80-90% of foreign bodies are found in the bronchus. [pedemmorsels.com]

• Cyanosis

  […] nuts), teeth, dental devices and medical instruments Some nuts, such as peanuts, have an oil that leads to inflammation and edema making them more difficult to expel Clinical Findings Many go undiscovered delaying diagnosis Cough Wheeze Stridor Dyspnea Cyanosis [learningradiology.com]

  TRACHEOBRONCHIAL TREE FOREIGN BODY  The   main symptoms are episodes of coughing, intermittent or continuous dyspnoea with cyanosis, pain, and intermittent hoarseness. 17. [slideshare.net]

  If the foreign body is large it may cause cyanosis and even death. The foreign body may also be coughed out. Intermediate stage: The patient is relatively symptomless. The period of this stage depends on the size and type of foreign body. [specialist-ent.com]

  Other common signs are cyanosis, choking, and dyspnea. However, delays in presentation for care are common, and concern about aspiration as a cause of the child’s symptoms may diminish as the primary event becomes more distant. [dontforgetthebubbles.com]

  Other common signs are cyanosis, choking, and dyspnea. However, delays in presentation for care are common, and concern about aspiration as a cause of the child's symptoms may diminish as the primary event becomes more distant. [hawaii.edu]

• Neglect

  Anesthetic management in removal of neglected tracheobronchial foreign body. J Anaesthesiol Clin Pharmacol 2013;29:127-8 How to cite this URL: Rangalakshmi S, Dixit N. Anesthetic management in removal of neglected tracheobronchial foreign body. [joacp.org]

Hence, further radiological workup may become necessary. Although widely recommended, inspiratory/expiratory chest films in infant and children usually do not prove very useful for technical reason. [jpma.org.pk]

[…] reported that out of 27,381 US emergency department visits in 2013 for suffocation injuries, as assessed using the Nationwide Emergency Department Sample database, 14,140 (51.6%) resulted from inhalation and ingestion of food. [11] Differential Diagnosis Workup [emedicine.medscape.com]

• Atelectasis

  This sign is particularly helpful when chest radiography shows atelectasis or pneumonia. The specificity of this sign for foreign bodies is only 71% because other endobronchial lesions can disrupt the air column. [ncbi.nlm.nih.gov]

  Clinical examination and lung ultrasound revealed an atelectasis of the left lower lobe. The etiologic assessment concluded to a bronchial foreign body. [austinpublishinggroup.com]

  This causes lung collapse (atelectasis), then pneumonia. As Dr. Chevalier Jackson stated, “Not all that wheezes is asthma!” Did You Know?! In the European Union each year, approximately 20 children (14 years or younger) die from choking on a toy. [dontchoke.ubc.ca]

  80% of aspirated foreign bodies will be non-opaque on conventional radiography Hyperinflation of one lung or lobe may occur (obstructive emphysema) Lobar or segmental atelectasis Mediastinal shift Pneumomediastinum Confirmatory imaging studies If the [learningradiology.com]

  There is atelectasis (collapse) predominantly affecting the right lower lobe (note the distinct right heart border on the AP film, and patchy opacities below the foreign body on the lateral film). [lifeinthefastlane.com]

• Pulmonary Infiltrate

  Other indirect signs of an airway foreign body include reabsorption atelectasis beyond the site of bronchial obstruction, and the presence of pulmonary infiltrates reflecting an inflammatory reaction. [dontforgetthebubbles.com]

BACKGROUND: Our objective was to assess types, presentation, duration of symptoms and usefulness of rigid bronchoscopy for diagnosis and treatment of bronchial foreign body (FB) in children. [ncbi.nlm.nih.gov]

On this lap of time, she did not feel any improvement despite the subscribed treatment. [austinpublishinggroup.com]

The greatest significance of our case is that it provides another possibility in diagnosis of endogenous foreign bodies and its treatment. [f1000research.com]

Delhi - 110 029, India Click here for correspondence address and email Date of Web Publication 22-Jul-2014 Abstract Background: Our objective was to assess types, presentation, duration of symptoms and usefulness of rigid bronchoscopy for diagnosis and treatment [afrjpaedsurg.org]

Machado Neves-Pinto Gustav Killian – a Milestone in the Otorhinolaryngology Int Arch Otorrinolaringol, 9 (2005), [2] Airways foreign bodies: clinical presentation, diagnosis and treatment European respiratory monograph. [archbronconeumol.org]

Mediastinitis or tracheoesophageal fistulas Air trapping leading Obstructive emphysema Atelectasis Post-obstructive pneumonia Abscess Bronchiectasis Prognosis Prognosis is excellent if the foreign body is removed expeditiously (within 24 hours) Aspirated [learningradiology.com]

Treatment and prognosis Bronchoscopy is considered the gold standard in the diagnosis of tracheobronchial tree foreign bodies 3, with the added benefit of being able to potentially retrieve the foreign body. [radiopaedia.org]

Park et al. mentioned that mucus impaction and plastic bronchitis are usually self-limited or responsive to medical therapy, with a good prognosis, although their patient did not respond to oral corticosteroid or intrabronchial instillation of acetylcysteine [f1000research.com]

Complications Complications include atelectasis, recurrent pneumonia, pulmonary compromise, and pulmonary infarct. [4] Prognosis The prognosis for complete tracheal obstruction from aspirated foreign body is grim, unless immediate action such as the Heimlich [emedicine.medscape.com]

The prognosis after removal of the foreign body is excellent. Complete recovery within a short time frame is generally expected. [clinicaladvisor.com]

The etiologic assessment concluded to a bronchial foreign body. Case Presentation A 78 years old lady presented to the emergency room with a three-month history of dry cough. [austinpublishinggroup.com]

ETIOLOGY Young children are susceptible because:     They lack molars for proper grinding of food. They tend to be running or playing at the time of aspiration. They tend to put objects in their mouth more frequently. [slideshare.net]

Mortality Another report by Cheng and colleagues determined that between 2000 and 2009, US pediatric inpatients with airway foreign bodies had a weighted mortality rate of approximately 2.75%, with the rate staying relatively unchanged over that period. [4] Etiology [emedicine.medscape.com]

Epidemiology Aspiration of foreign bodies by children can lead to serious illness and sometimes even death. [pedsinreview.aappublications.org]

Inhaling foreign bodies: An epidemiological, clinical study of 92 cases. Acta Otorhinolaryngol Ital 1997; 17(1): 45-51. 6. Ashoore A, Baraka M, Kholania E. Foreign bodies in paediatric tracheobrochial tree. Saudi Med J 1987; 5: 481-86. 7. [ijaweb.org]

Epidemiology Frequency Most airway foreign body aspirations occur in children younger than 15 years; children aged 1-3 years are the most susceptible. [emedicine.medscape.com]

Epidemiology Ages affected (typical range 1 to 4 years old) Age under 3 years old: 50% Age under 4 years old: 80% Age under 10 years old: 95% Increased Incidence at holiday time Known object aspiration in less than 40% of cases Choking deaths related [fpnotebook.com]

Although the pathophysiology is not clearly understood, it is commonly seen in children with congenital heart diseases, cardiac and pericardial diseases in adults and in patients with chronic asthma 6. [f1000research.com]

PATHOPHYSIOLOGY  Food items are aspirated most commonly;  Peanuts are the most frequently aspirated food  After foreign body aspiration occurs, the foreign body can settle into 3 anatomic sites, the larynx, trachea, or bronchus. 5. [slideshare.net]

What is the pathophysiological significance of the size of the aspirated object? Answer and interpretation Large objects tend to lodge in the upper airway and trachea (about 20% of airway foreign bodies). [lifeinthefastlane.com]

Pathophysiology After foreign body aspiration occurs, the foreign body can settle into 3 anatomic sites, the larynx, trachea, or bronchus. Of aspirated foreign bodies, 80-90% become lodged in the bronchi. [emedicine.medscape.com]

Prevention of pulmonary aspiration. [ijaweb.org]

[…] around it and difficulty to catch its slipping edges. using the tunnel inside the beads to insert a Fogarty catheter then inflate the balloon and gentle withdrawal of the bronchoscopy system as one unit is an alternative apporach for this difficult FB to prevent [ctsnet.org]

Early diagnosis and removal are imperative to prevent mortality as well as complications. A 45 year old heroine (diamorphine) addict was brought to the emergency department in a gasping state, with a history of substance abuse. [apicareonline.com]

Prevention No child less than 15 months old should be offered foods such as popcorn, hard lollies, raw carrot or apples. Children under the age of 4 years should not be offered peanuts. [rch.org.au]