Foreign bodies in airways

S. Casale, A. Melagrana, P. Di Pietro, P. O. Gianiorio, O. Sacco, R. Vallarino, Vincenzo Tarantino

Research output: Contribution to journalArticle

Abstract

Objectives. Aim of the present study was to collect epidemiologic, clinical and instrumental data in our case series and to establish preventive, diagnostic and therapeutic criteria. Methods. Data concerning 148 patients with foreign bodies in airways are reported. All patients underwent clinical, radiological and endoscopic evaluation. Results. Foreign body inhalation shows a peak incidence at 1 - 3 years of age with prevalence in males. The most frequent foreign bodies inhaled are dried fruit (57 cases: 38.5%) and plastic objects (27 cases: 18.2%). In 19.6% of cases, foreign bodies are lodged in the larynx, in 6.8% in the trachea, and in the remaining 73.6% in the bronchial tract (above all the main bronchi) with a prevalence in the right bronchus. In 69.7% of patients, clinical history suggested a penetration syndrome, while in 18.2% the presence of a foreign body was suggested by repeated bronchopulmonary episodes in the same site in a patient without any previous similar respiratory symptoms. The most frequent symptoms of bronchial localiszation were: cough, wheezing, dyspnoea, and fever. Radiographic examinations were used to visualize the inhaled object in 13 cases (8.8%); indirect radiological signs were present in the remaining patients. In conclusion, 59.7% of foreign bodies were correctly diagnosed within 7 days of inhalation (within 3 days in 50% of total cases), whereas 18.6% were diagnosed between 30 and 90 days. This delay may be attributed to the polymorphism of clinical symptoms. All foreign bodies were removed endoscopically and operative complications were rare (mild bleeding in 3 cases; pneumothorax in 2). Conclusions. Currently, the fiberbronchoscope allows safe diagnosis of foreign body inhalation with no morbidity for the patient, while foreign body extraction requires the use of the rigid bronchoscope. Correct diagnosis and adequate surgery are feasible only through a multidisciplinary approach to the patient. Close collaboration between anaesthetist and endoscopist is essential for optimal execution of extractive tracheobronchoscopy, and collaboration between otolaryngologist and pneumologist is mandatory for foreign body diagnostic and therapeutic management.

Original languageEnglish
Pages (from-to)226-230
Number of pages5
JournalItalian Journal of Pediatrics
Volume33
Issue number4
Publication statusPublished - Aug 2007

Fingerprint

Foreign Bodies
Inhalation
Bronchi
Bronchoscopes
Respiratory Sounds
Pneumothorax
Larynx
Trachea
Cough
Dyspnea
Plastics
Fruit
Fever
Hemorrhage
Morbidity
Incidence
Therapeutics

Keywords

  • Airways
  • Child
  • Tracheobronchial foreign body

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Casale, S., Melagrana, A., Di Pietro, P., Gianiorio, P. O., Sacco, O., Vallarino, R., & Tarantino, V. (2007). Foreign bodies in airways. Italian Journal of Pediatrics, 33(4), 226-230.

Foreign bodies in airways. / Casale, S.; Melagrana, A.; Di Pietro, P.; Gianiorio, P. O.; Sacco, O.; Vallarino, R.; Tarantino, Vincenzo.

In: Italian Journal of Pediatrics, Vol. 33, No. 4, 08.2007, p. 226-230.

Research output: Contribution to journalArticle

Casale, S, Melagrana, A, Di Pietro, P, Gianiorio, PO, Sacco, O, Vallarino, R & Tarantino, V 2007, 'Foreign bodies in airways', Italian Journal of Pediatrics, vol. 33, no. 4, pp. 226-230.
Casale S, Melagrana A, Di Pietro P, Gianiorio PO, Sacco O, Vallarino R et al. Foreign bodies in airways. Italian Journal of Pediatrics. 2007 Aug;33(4):226-230.
Casale, S. ; Melagrana, A. ; Di Pietro, P. ; Gianiorio, P. O. ; Sacco, O. ; Vallarino, R. ; Tarantino, Vincenzo. / Foreign bodies in airways. In: Italian Journal of Pediatrics. 2007 ; Vol. 33, No. 4. pp. 226-230.
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abstract = "Objectives. Aim of the present study was to collect epidemiologic, clinical and instrumental data in our case series and to establish preventive, diagnostic and therapeutic criteria. Methods. Data concerning 148 patients with foreign bodies in airways are reported. All patients underwent clinical, radiological and endoscopic evaluation. Results. Foreign body inhalation shows a peak incidence at 1 - 3 years of age with prevalence in males. The most frequent foreign bodies inhaled are dried fruit (57 cases: 38.5{\%}) and plastic objects (27 cases: 18.2{\%}). In 19.6{\%} of cases, foreign bodies are lodged in the larynx, in 6.8{\%} in the trachea, and in the remaining 73.6{\%} in the bronchial tract (above all the main bronchi) with a prevalence in the right bronchus. In 69.7{\%} of patients, clinical history suggested a penetration syndrome, while in 18.2{\%} the presence of a foreign body was suggested by repeated bronchopulmonary episodes in the same site in a patient without any previous similar respiratory symptoms. The most frequent symptoms of bronchial localiszation were: cough, wheezing, dyspnoea, and fever. Radiographic examinations were used to visualize the inhaled object in 13 cases (8.8{\%}); indirect radiological signs were present in the remaining patients. In conclusion, 59.7{\%} of foreign bodies were correctly diagnosed within 7 days of inhalation (within 3 days in 50{\%} of total cases), whereas 18.6{\%} were diagnosed between 30 and 90 days. This delay may be attributed to the polymorphism of clinical symptoms. All foreign bodies were removed endoscopically and operative complications were rare (mild bleeding in 3 cases; pneumothorax in 2). Conclusions. Currently, the fiberbronchoscope allows safe diagnosis of foreign body inhalation with no morbidity for the patient, while foreign body extraction requires the use of the rigid bronchoscope. Correct diagnosis and adequate surgery are feasible only through a multidisciplinary approach to the patient. Close collaboration between anaesthetist and endoscopist is essential for optimal execution of extractive tracheobronchoscopy, and collaboration between otolaryngologist and pneumologist is mandatory for foreign body diagnostic and therapeutic management.",
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