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The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation

Year 2021, Volume: 16 Issue: 2, 149 - 153, 07.07.2021
https://doi.org/10.17517/ksutfd.896763

Abstract

Background and Aims: Foreign body aspiration (FBA) is frequently seen in children, and progresses with symptoms related to airway obstruction, leading to serious complications. The aim of this study was to discuss the diagnosis and treatment principles of patients who underwent bronchoscopy for suspected foreign body aspiration (FBA), and to emphasize its preventability.
Method: A retrospective review was made of the records of patients who underwent bronchoscopy for evaluation of FBA in the Pediatric Surgery Clinics of two hospitals where the authors work from January 2017 to February 2020. Age, gender, history of FBA, clinical symptoms, chest radiography findings, bronchoscopy findings, complications, and outcome were recorded for each patient. A history of FBA, physical examination findings, and radiological study results were analyzed statistically to determine the most accurate diagnostic tool to differentiate cases with and without FBA.
Results: Bronchoscopy was performed in 102 patients with suspected FBA. A foreign body was detected in 51% (52/102) of the patients. No statistically significant difference was determined in respect of age and gender (p>0.005). There was a statistically significant difference in respect of history and time of presentation, but no difference in terms of physical examination and radiological findings. Of the foreign bodies aspirated, 87% were nuts. No life-threatening complications occurred in any patient due to bronchoscopy.
Conclusion: Nuts are the most frequently aspirated foreign bodies in childhood. History, physical examination, and radiological findings may not be available for all patients. Preventive measures are important as FBA can lead to fatal consequences. Careful evaluation of the patient is necessary to reduce the negative bronchoscopy rate.

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References

  • References: 1. Ciftci AO, Bingöl-Koloğlu M, Senocak ME, Tanyel FC, Büyükpamukçu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg. 2003 Aug;38(8):1170-6
  • 2. Şenkaya I, Sağdıç K, Gebitekin C, Yılmaz M, Özkan H, Cengiz M. Management of foreign body aspiration in infancy and childhood. Turk J Ped 1997;39:353-62.
  • 3. Smitheringale A. Management of foreignbodies of the tracheobronchial tree. In: Pearson editor. Thoracic surgery. Philadelphia: Churchil Livingstone; 1995. p. 1591-9.
  • 4. Zekeriya İ. Çocuklarda Trakeobronşial Yabancı Cisim Aspirasyonu. Kocaeli Tıp Dergisi 2012;2: 47-54
  • 5. Hsu Wc, Sheen Ts, Lin Cd, Tan Ct, Yeh Th, Lee Sy. Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: a series of 3217 cases from 1970 to 1996. Otolaryngol Head Neck Surg. 2000 Mar;122(3):450-4
  • 6. Özyüksel G, Arslan UE, Boybeyi Türer Ö, Tanyel FC, Soyer T . New scoring system to predict foreign body aspiration in children, J Pediatr Surg 55 (2020) 1663–1666
  • 7. Tütüncü AÇ, Dilmen ÖK, Ozcan R, Emre Ş, Köksal G, Altıntaş F et al.. Çocuk hastalarda yabancı cisim aspirasyonu nedeniyle uygulanan rijid bronkoskopi sonuçlarımız. Turk Ped Arş 2012;47:125-9.
  • 8. Sarısoy Ö, Liman ŞT, Aydoğan M, Topçu S, Burç K, Hatun Ş. Çocukluk çağı yabancı cisim aspirasyonları: klinik ve radyolojik değerlendirme. Çocuk Sağlığı ve Hastalıkları Dergisi 2007;50:96-101
  • 9. Chouhan M, Sharma S. Tracheobronchial Foreign Bodies: The Importance of Timely Intervention and Appropriate Collaboration. Indian J Otolaryngol Head Neck Surg. 2019;71:972-97
  • 10. Jaswal A, Jana U, Maiti PK. Tracheo-bronchial foreign bodies: a retrospective study and review of literature. Indian J Otolaryngol Head Neck Surg. 2014;66:156-60
  • 11. Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg. 2008;43(4):718-21.
  • 12. Özsoylu S, Akyıldız B, Dursun A. Yabancı Cisim Aspirasyonu: 6 yıllık deneyimlerimiz. Bozok Tıp Derg 2017;7(3):43-6
  • 13. Tokar B, Ozkan R, Ilhan H. Tracheobronchial foreign bodies in children:importance of accurate history and plain chest radiography in delayed presentation. Clin Radiol. 2004 Jul;59(7):609-15
  • 14. Oncel M, Sunam GS, Ceran S. Tracheobronchial aspiration of foreign bodies and rigid bronchoscopy in children. Pediatr Int. 2012 Aug;54(4):532-5.
  • 15. Hitter A, Hullo E, Durand C, Righini CA. Diagnostic value of variousinvestigations in children with suspected foreign body aspiration: review. Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Nov;128(5):248-52.
  • 16. Qiu W, Wu L, Chen Z. Foreign body aspiration in children with negative multi-detector Computed Tomography results: Own experience during 2011-2018. Int J Pediatr Otorhinolaryngol. 2019 Sep;124:90-93.
  • 17. http://www.tuksiad.org/uploads/yuklemeler/tuksiad-mda-2014.
  • 18. Mahafza T, Khader Y. Aspirated tracheobronchial foreign bodies: a Jordanian experience. Ear Nose Throat J. 2007 Feb;86(2):107-10.
  • 19. Erginel B, Haspulat M, Soysal FG, Özber H, Keskin E, Karlı G et al.. Rigid bronchoscopy ın the treatment of foreıgn body aspıratıon. J Ist Faculty Med 2016; 79: 3
  • 20. Yıldırım M, Doğusoy I, Okay T, Yaşaroğlu M, Demirbağ H, Aydemir B et al. Tracheobronchıal foreıgn bodıes. Turkish J Thorac Cardiovasc Surg 2003;11:228-231
  • 21. Ludemann JP, Hughes CA, Holinger LD. Management of foreign bodies of the airway. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. Philadelphia: WB Saunders, 2000;73:853-62

Yanıbaşımızdaki Tehlike: Çocuklarda Yabancı Cisim Aspirasyonu, Önleme, Tanı ve Tedavi Değerlendirmesi

Year 2021, Volume: 16 Issue: 2, 149 - 153, 07.07.2021
https://doi.org/10.17517/ksutfd.896763

Abstract

Giriş ve Amaç: Yabancı cisim aspirasyonu çocuklarda sık görülür ve hava yolu obstrüksiyonuna bağlı semptomlarla ilerleyerek ciddi komplikasyonlara yol açar. Bu çalışmanın amacı şüpheli yabancı cisim aspirasyonu nedeniyle bronkoskopi yapılan hastaların uygun tanı araçlarını ve tedavi prensiplerini tartışmak ve önlenebilirliğini vurgulamaktır.
Yöntem: Yazarların çalıştığı iki hastanenin Çocuk Cerrahisi Kliniklerinde Ocak 2017'den Şubat 2020 tarihleri arasında, yabancı cisim aspirasyonu değerlendirilmesi için bronkoskopi yapılan hastaların kayıtları geriye dönük olarak incelendi. Yaş, cinsiyet, yabancı cisim aspirasyonu öyküsü, klinik semptomlar, akciğer grafisi bulguları, bronkoskopi bulguları, komplikasyonlar kaydedildi. Yabancı cisim aspirasyonu öyküsü, fizik muayene bulguları ve akciğer grafisi bulguları, yabancı cisim varlığını tespit için bronkoskopi öncesi en uygun tanı aracını bulmak amacıyla istatistiksel olarak incelendi.
Bulgular: Yabancı cisim aspirasyonu şüphesi olan 102 hastaya bronkoskopi yapıldı. Hastaların% 51'inde (52/102) yabancı cisim tespit edildi. Yaş ve cinsiyet açısından istatistiksel olarak anlamlı bir fark saptanmadı (p> 0,005). Öykü ve başvuru zamanı açısından istatistiksel olarak anlamlı fark bulunurken, fizik muayene ve radyolojik bulgular açısından fark bulunmadı. Aspire edilen yabancı cisimlerin % 87'si kuruyemiş idi. Bronkoskopiye bağlı hiçbir hastada hayatı tehdit eden bir komplikasyon oluşmadı.
Sonuç: Kuruyemişler, çocukluk çağında en sık aspire edilen yabancı cisimlerdir. Hastalarda öykü, fizik muayene ve radyolojik bulguların normal olabileceği unutulmamalıdır. Önleyici tedbirler, ölümcül sonuçlar doğurabilen aspirasyon için hepsinden önemlidir. Negatif bronkoskopi oranını azaltmak için hastanın dikkatli değerlendirilmesi gerekir.

References

  • References: 1. Ciftci AO, Bingöl-Koloğlu M, Senocak ME, Tanyel FC, Büyükpamukçu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg. 2003 Aug;38(8):1170-6
  • 2. Şenkaya I, Sağdıç K, Gebitekin C, Yılmaz M, Özkan H, Cengiz M. Management of foreign body aspiration in infancy and childhood. Turk J Ped 1997;39:353-62.
  • 3. Smitheringale A. Management of foreignbodies of the tracheobronchial tree. In: Pearson editor. Thoracic surgery. Philadelphia: Churchil Livingstone; 1995. p. 1591-9.
  • 4. Zekeriya İ. Çocuklarda Trakeobronşial Yabancı Cisim Aspirasyonu. Kocaeli Tıp Dergisi 2012;2: 47-54
  • 5. Hsu Wc, Sheen Ts, Lin Cd, Tan Ct, Yeh Th, Lee Sy. Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: a series of 3217 cases from 1970 to 1996. Otolaryngol Head Neck Surg. 2000 Mar;122(3):450-4
  • 6. Özyüksel G, Arslan UE, Boybeyi Türer Ö, Tanyel FC, Soyer T . New scoring system to predict foreign body aspiration in children, J Pediatr Surg 55 (2020) 1663–1666
  • 7. Tütüncü AÇ, Dilmen ÖK, Ozcan R, Emre Ş, Köksal G, Altıntaş F et al.. Çocuk hastalarda yabancı cisim aspirasyonu nedeniyle uygulanan rijid bronkoskopi sonuçlarımız. Turk Ped Arş 2012;47:125-9.
  • 8. Sarısoy Ö, Liman ŞT, Aydoğan M, Topçu S, Burç K, Hatun Ş. Çocukluk çağı yabancı cisim aspirasyonları: klinik ve radyolojik değerlendirme. Çocuk Sağlığı ve Hastalıkları Dergisi 2007;50:96-101
  • 9. Chouhan M, Sharma S. Tracheobronchial Foreign Bodies: The Importance of Timely Intervention and Appropriate Collaboration. Indian J Otolaryngol Head Neck Surg. 2019;71:972-97
  • 10. Jaswal A, Jana U, Maiti PK. Tracheo-bronchial foreign bodies: a retrospective study and review of literature. Indian J Otolaryngol Head Neck Surg. 2014;66:156-60
  • 11. Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg. 2008;43(4):718-21.
  • 12. Özsoylu S, Akyıldız B, Dursun A. Yabancı Cisim Aspirasyonu: 6 yıllık deneyimlerimiz. Bozok Tıp Derg 2017;7(3):43-6
  • 13. Tokar B, Ozkan R, Ilhan H. Tracheobronchial foreign bodies in children:importance of accurate history and plain chest radiography in delayed presentation. Clin Radiol. 2004 Jul;59(7):609-15
  • 14. Oncel M, Sunam GS, Ceran S. Tracheobronchial aspiration of foreign bodies and rigid bronchoscopy in children. Pediatr Int. 2012 Aug;54(4):532-5.
  • 15. Hitter A, Hullo E, Durand C, Righini CA. Diagnostic value of variousinvestigations in children with suspected foreign body aspiration: review. Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Nov;128(5):248-52.
  • 16. Qiu W, Wu L, Chen Z. Foreign body aspiration in children with negative multi-detector Computed Tomography results: Own experience during 2011-2018. Int J Pediatr Otorhinolaryngol. 2019 Sep;124:90-93.
  • 17. http://www.tuksiad.org/uploads/yuklemeler/tuksiad-mda-2014.
  • 18. Mahafza T, Khader Y. Aspirated tracheobronchial foreign bodies: a Jordanian experience. Ear Nose Throat J. 2007 Feb;86(2):107-10.
  • 19. Erginel B, Haspulat M, Soysal FG, Özber H, Keskin E, Karlı G et al.. Rigid bronchoscopy ın the treatment of foreıgn body aspıratıon. J Ist Faculty Med 2016; 79: 3
  • 20. Yıldırım M, Doğusoy I, Okay T, Yaşaroğlu M, Demirbağ H, Aydemir B et al. Tracheobronchıal foreıgn bodıes. Turkish J Thorac Cardiovasc Surg 2003;11:228-231
  • 21. Ludemann JP, Hughes CA, Holinger LD. Management of foreign bodies of the airway. In: Shields TW, LoCicero J, Ponn RB, eds. General Thoracic Surgery. Philadelphia: WB Saunders, 2000;73:853-62
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Araştırma Makaleleri
Authors

Ali Erdal Karakaya 0000-0003-0241-7646

Ahmet Gökhan Güler 0000-0003-4740-3512

Ahmet Burak Doğan 0000-0003-1544-4598

Dilan Altıntaş Ural 0000-0002-1976-9122

Serkan Arslan 0000-0002-5879-4478

Publication Date July 7, 2021
Submission Date March 14, 2021
Acceptance Date April 12, 2021
Published in Issue Year 2021 Volume: 16 Issue: 2

Cite

AMA Karakaya AE, Güler AG, Doğan AB, Altıntaş Ural D, Arslan S. The Danger Close to Home: Foreign body aspiration in the children, prevention, diagnosis and treatment evaluation. KSU Medical Journal. July 2021;16(2):149-153. doi:10.17517/ksutfd.896763