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Clinico-radiological parameters predicting early diagnosis of foreign body aspiration in children

Yıl 2016, Cilt: 26 Sayı: 5, 268 - 275, 20.10.2016

Öz

Objectives: This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body FB aspiration in children. Patients and Methods: This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children 22 males, 15 females; mean age 2.6 years; range 1 to 12 years with positive for FB on bronchoscopy were analyzed. Results: Penetration syndrome sudden onset coughing, choking and gagging 89.2% and decreased breath sounds 86.5% were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation 64.9% , mediastinal shift 45.9% , and collapse 21.6% were common radiological signs on chest radiography and in 13.5% patients the chest X-rays were normal. Sites of FB lodgements were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases peanut 54.1% and inorganic FBs were present in seven cases. Conclusion: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.

Kaynakça

  • Jackson C, Jackson CL. Diseases of the air and food passages of foreign body origin. Philadelphia: W.B Saunders Co; 1936.
  • Svedström E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 1989;19:520-2.
  • Steen KH, Zimmermann T. Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases. Laryngoscope 1990;100:525-30.
  • Mantor PC, Tuggle DW, Tunell WP. An appropriate negative bronchoscopy rate in suspected foreign body aspiration. Am J Surg 1989;158:622-4.
  • Zerella JT, Dimler M, McGill LC, Pippus KJ. Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 1998;33:1651-4.
  • Black RE, Johnson DG, Matlak ME. Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg 1994;29:682-4.
  • Wiseman NE. The diagnosis of foreign body aspiration in childhood. J Pediatr Surg 1984;19:531-5.
  • Banerjee A, Rao KS, Khanna SK, Narayanan PS, Gupta BK, Sekar JC, et al. Laryngo-tracheo-bronchial foreign bodies in children. J Laryngol Otol 1988;102:1029-32.
  • Narasimhan KL, Chowdhary SK, Suri S, Mahajan JK, Samujh R, Rao KLN. Foreign body airway obstructions in children- lessons learnt from a prospective audit. J Indian Assoc Pediatr Surg 2002;7:184-9.
  • Tahir N, Ramsden WH, Stringer MD. Tracheobronchial anatomy and the distribution of inhaled foreign bodies in children. Eur J Pediatr 2009;168:289-95.
  • Roh JL, Hong SJ. Lung recovery after rigid bronchoscopic removal of tracheobronchial foreign bodies in children. Int J Pediatr Otorhinolaryngol 2008;72:635-41.
  • Chik KK, Miu TY, Chan CW. Foreign body aspiration in Hong Kong Chinese children. Hong Kong Med J 2009;15:6-11.
  • Roda J, Nobre S, Pires J, Estêvão MH, Félix M. Foreign bodies in the airway: a quarter of a century's experience. Rev Port Pneumol 2008;14:787-802.
  • Fraga Ade M, Reis MC, Zambon MP, Toro IC, Ribeiro JD, Baracat EC. Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment. J Bras Pneumol 2008;34:74-82.
  • Sinha V, Memon R, Gupta D, Prajapati B, Bhat V, More Y. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg 2007;59:211-4.
  • Saki N, Nikakhlagh S, Rahim F, Abshirini H. Foreign body aspirations in infancy: a 20-year experience. Int J Med Sci 2009;6:322-8.
  • Findlay CA, Morrissey S, Paton JY. Subcutaneous emphysema secondary to foreign-body aspiration. Pediatr Pulmonol 2003;36:81-2.
  • Maunder RJ, Pierson DJ, Hudson LD. Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management. Arch Intern Med 1984;144:1447-53.
  • Saoji R, Ramchandra C, D'Cruz AJ. Subcutaneous emphysema: an unusual presentation of foreign body in the airway. J Pediatr Surg 1995;30:860-2.
  • Paşaoğlu I, Doğan R, Demircin M, Hatipoğlu A, Bozer AY. Bronchoscopic removal of foreign bodies in children: retrospective analysis of 822 cases. Thorac Cardiovasc Surg 1991;39:95-8.
  • Chung MK, Jeong HS, Ahn KM, Park SH, Cho JK, Son YI, et al. Pulmonary recovery after rigid bronchoscopic retrieval of airway foreign body. Laryngoscope 2007;117:303-7.

Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler

Yıl 2016, Cilt: 26 Sayı: 5, 268 - 275, 20.10.2016

Öz

Amaç: Bu çalışmada çocuklarda yabancı cisim YC aspirasyonu erken tanısı için klinik ve radyolojik bulgular araştırıldı.Hastalar ve Yöntemler: Bu prospektif çalışma Eylül 2010 - Mayıs 2014 tarihleri arasında, YC aspirasyonu klinik tanısı ile rijid bronkoskopi uygulanan 12 yaşından küçük 45 çocuk ile yürütüldü. Otuz yedi YC pozitif çocuğun sonuçları 22 erkek, 15 kız; ort. yaş 2.6 yıl; dağılım 1-12 yıl bronkoskopi ile analiz edildi.Bulgular: Penetrasyon sendromu ani başlangıçlı öksürük, boğulma ve tıkanma %89.2 ve azalmış solunum sesleri %86.5 en sık görülen klinik özelliklerdi. Öksürük, solunum zorluğu ve ateş sırasıyla %83.8, %78.4 ve %27 idi. Takipne, taşikardi, göğüs çekilmeleri, azalmış göğüs hareketleri ve hırıltı sırasıyla %83.3, %83.3, %83.3, %51.4 ve %43.2 idi. Tek taraflı hiperinflasyon %64.9 , mediastinal şift %45.9 ve çökme %21.6 akciğer grafisinde ve göğüs röntgenlerinde ortak radyolojik bulgulardı ve hastaların %13.5’inin akciğer filmi normaldi. Yabancı cisim yerleşim yerleri gırtlak, soluk borusu, sağ ana bronş, sol ana bronş ve iki taraflı bronşlarda sırasıyla %10.8, %10.8, %35.1, %37.8 ve %5.5 idi. Gıda ile ilgili YC’ler 30 olguda yer fıstığı %54.1 ve inorganik YC yedi olguda mevcuttu.Sonuç: Penetrasyon sendromu, lokalize solunum sesleri azalması, tek taraflı hiperenflasyon veya radyolojide mediastinal şift YC aspirasyonu erken tanısı için gösterge niteliğindedir

Kaynakça

  • Jackson C, Jackson CL. Diseases of the air and food passages of foreign body origin. Philadelphia: W.B Saunders Co; 1936.
  • Svedström E, Puhakka H, Kero P. How accurate is chest radiography in the diagnosis of tracheobronchial foreign bodies in children? Pediatr Radiol 1989;19:520-2.
  • Steen KH, Zimmermann T. Tracheobronchial aspiration of foreign bodies in children: a study of 94 cases. Laryngoscope 1990;100:525-30.
  • Mantor PC, Tuggle DW, Tunell WP. An appropriate negative bronchoscopy rate in suspected foreign body aspiration. Am J Surg 1989;158:622-4.
  • Zerella JT, Dimler M, McGill LC, Pippus KJ. Foreign body aspiration in children: value of radiography and complications of bronchoscopy. J Pediatr Surg 1998;33:1651-4.
  • Black RE, Johnson DG, Matlak ME. Bronchoscopic removal of aspirated foreign bodies in children. J Pediatr Surg 1994;29:682-4.
  • Wiseman NE. The diagnosis of foreign body aspiration in childhood. J Pediatr Surg 1984;19:531-5.
  • Banerjee A, Rao KS, Khanna SK, Narayanan PS, Gupta BK, Sekar JC, et al. Laryngo-tracheo-bronchial foreign bodies in children. J Laryngol Otol 1988;102:1029-32.
  • Narasimhan KL, Chowdhary SK, Suri S, Mahajan JK, Samujh R, Rao KLN. Foreign body airway obstructions in children- lessons learnt from a prospective audit. J Indian Assoc Pediatr Surg 2002;7:184-9.
  • Tahir N, Ramsden WH, Stringer MD. Tracheobronchial anatomy and the distribution of inhaled foreign bodies in children. Eur J Pediatr 2009;168:289-95.
  • Roh JL, Hong SJ. Lung recovery after rigid bronchoscopic removal of tracheobronchial foreign bodies in children. Int J Pediatr Otorhinolaryngol 2008;72:635-41.
  • Chik KK, Miu TY, Chan CW. Foreign body aspiration in Hong Kong Chinese children. Hong Kong Med J 2009;15:6-11.
  • Roda J, Nobre S, Pires J, Estêvão MH, Félix M. Foreign bodies in the airway: a quarter of a century's experience. Rev Port Pneumol 2008;14:787-802.
  • Fraga Ade M, Reis MC, Zambon MP, Toro IC, Ribeiro JD, Baracat EC. Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment. J Bras Pneumol 2008;34:74-82.
  • Sinha V, Memon R, Gupta D, Prajapati B, Bhat V, More Y. Foreign body in tracheobronchial tree. Indian J Otolaryngol Head Neck Surg 2007;59:211-4.
  • Saki N, Nikakhlagh S, Rahim F, Abshirini H. Foreign body aspirations in infancy: a 20-year experience. Int J Med Sci 2009;6:322-8.
  • Findlay CA, Morrissey S, Paton JY. Subcutaneous emphysema secondary to foreign-body aspiration. Pediatr Pulmonol 2003;36:81-2.
  • Maunder RJ, Pierson DJ, Hudson LD. Subcutaneous and mediastinal emphysema. Pathophysiology, diagnosis, and management. Arch Intern Med 1984;144:1447-53.
  • Saoji R, Ramchandra C, D'Cruz AJ. Subcutaneous emphysema: an unusual presentation of foreign body in the airway. J Pediatr Surg 1995;30:860-2.
  • Paşaoğlu I, Doğan R, Demircin M, Hatipoğlu A, Bozer AY. Bronchoscopic removal of foreign bodies in children: retrospective analysis of 822 cases. Thorac Cardiovasc Surg 1991;39:95-8.
  • Chung MK, Jeong HS, Ahn KM, Park SH, Cho JK, Son YI, et al. Pulmonary recovery after rigid bronchoscopic retrieval of airway foreign body. Laryngoscope 2007;117:303-7.
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma Makalesi
Yazarlar

Pradipta Kumar Parida Bu kişi benim

Nirmal Shanmugasundaram Bu kişi benim

Surianarayanan Gopalakrishnan Bu kişi benim

Yayımlanma Tarihi 20 Ekim 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 26 Sayı: 5

Kaynak Göster

APA Kumar Parida, P., Shanmugasundaram, N., & Gopalakrishnan, S. (2016). Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler. The Turkish Journal of Ear Nose and Throat, 26(5), 268-275.
AMA Kumar Parida P, Shanmugasundaram N, Gopalakrishnan S. Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler. Tr-ENT. Ekim 2016;26(5):268-275.
Chicago Kumar Parida, Pradipta, Nirmal Shanmugasundaram, ve Surianarayanan Gopalakrishnan. “Çocuklarda Yabancı Cisim Aspirasyonu Erken tanısını öngören Klinik-Radyolojik Parametreler”. The Turkish Journal of Ear Nose and Throat 26, sy. 5 (Ekim 2016): 268-75.
EndNote Kumar Parida P, Shanmugasundaram N, Gopalakrishnan S (01 Ekim 2016) Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler. The Turkish Journal of Ear Nose and Throat 26 5 268–275.
IEEE P. Kumar Parida, N. Shanmugasundaram, ve S. Gopalakrishnan, “Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler”, Tr-ENT, c. 26, sy. 5, ss. 268–275, 2016.
ISNAD Kumar Parida, Pradipta vd. “Çocuklarda Yabancı Cisim Aspirasyonu Erken tanısını öngören Klinik-Radyolojik Parametreler”. The Turkish Journal of Ear Nose and Throat 26/5 (Ekim 2016), 268-275.
JAMA Kumar Parida P, Shanmugasundaram N, Gopalakrishnan S. Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler. Tr-ENT. 2016;26:268–275.
MLA Kumar Parida, Pradipta vd. “Çocuklarda Yabancı Cisim Aspirasyonu Erken tanısını öngören Klinik-Radyolojik Parametreler”. The Turkish Journal of Ear Nose and Throat, c. 26, sy. 5, 2016, ss. 268-75.
Vancouver Kumar Parida P, Shanmugasundaram N, Gopalakrishnan S. Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler. Tr-ENT. 2016;26(5):268-75.