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Removal of foreign body (bottom of pen) in bronchus: An innovative technique. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2020.101766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Sultan TA, van As AB. Review of tracheobronchial foreign body aspiration in the South African paediatric age group. J Thorac Dis 2016; 8:3787-3796. [PMID: 28149578 DOI: 10.21037/jtd.2016.12.90] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Children, and in particular young children under the age of three, are the most vulnerable for aspiration and ingestion of foreign bodies (FBs). The Red Cross War Memorial Children's Hospital in Cape Town is the only children's hospital in South Africa and is unique in having a dedicated trauma unit for children under the age of 13 as part of its institution. Core activities of Childsafe South Africa (CSA), located at the hospital, are data accumulation and interpretation, development of educational programmes, health inculcation and advising in legislation involving child health. To achieve this task, CSA works in close co-operation with government, industry, non-governmental and community predicated organisations, community groups and individuals. A database of all children treated for trauma at CSA has been maintained since 1991; it currently contains detailed information of over 170,000 injuries in children under the age of 13. This review consists of a literature review combined with data from our database and aims to provide information on our experiences with tracheobronchial aspiration of FBs in children.
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Affiliation(s)
- Tamer Ali Sultan
- Trauma Unit, Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa;; Paediatric Surgery Unit, Department of General Surgery, Menoufia University, Shebeen El-Kom, Egypt
| | - Arjan Bastiaan van As
- Trauma Unit, Division of Paediatric Surgery, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Rodríguez H, Cuestas G, Botto H, Nieto M, Cocciaglia A, Passali D, Gregori D. Complications in Children From Foreign Bodies in the Airway. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016. [DOI: 10.1016/j.otoeng.2016.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rodríguez H, Cuestas G, Botto H, Nieto M, Cocciaglia A, Passali D, Gregori D. Complications in children from foreign bodies in the airway. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015; 67:93-101. [PMID: 25857247 DOI: 10.1016/j.otorri.2015.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 12/23/2014] [Accepted: 01/14/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND OBJECTIVES Foreign body aspiration in childhood is a common and potentially serious problem. Complications may be the result of the aspiration episode itself, delayed diagnosis or treatment. We describe our experience in a paediatric hospital in Argentina. METHODS We retrospectively evaluated 56 patients with complications due to foreign body aspiration recorded in the Susy Safe Project between January 2010 and November 2013. The clinical variables analysed were sex, age at time of aspiration, foreign body location and type, time elapsed from the event until object removal, extraction technique, complications, need for hospitalisation and circumstances of the event. RESULTS 58.9% of the cases described occurred in males, with high presence of adults (76.8%) at the time of aspiration. The incidence was slightly higher in children older than 3 years. In 37 cases (66.1%), the foreign body was located in bronchus; sunflower seeds and ballpoint caps were the most common foreign objects. Only in 10 cases (17.9%) was the object extracted within 24h of the event. The most common complications were pneumonia (18 cases), granuloma (15 cases) and mucosal erosion (9 cases). Hospitalisation was necessary for 41 patients. CONCLUSION Early diagnosis and immediate control through specialised teams are essential to ensure proper treatment, usually endoscopic, without risk of complications.
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Affiliation(s)
- Hugo Rodríguez
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Giselle Cuestas
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.
| | - Hugo Botto
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Mary Nieto
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Alejandro Cocciaglia
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Desiderio Passali
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
| | - Dario Gregori
- Servicio de Endoscopia Respiratoria, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina
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Abstract
Smothering is defined as an obstruction of the air passages above the level of the epiglottis, including the nose, mouth, and pharynx. This is in contrast to choking, which is considered to be due to an obstruction of the air passages below the epiglottis. The manner of death in smothering can be homicidal, suicidal, or an accident. Accidental smothering is considered to be a rare event among middle-aged adults, yet many cases still occur. Presented here is the case of a 39-year-old woman with a history of bipolar disease who was found dead on her living room floor by her neighbors. Her hands were covered in scratches and her pet cat was found disemboweled in the kitchen with its tail hacked off. On autopsy her stomach was found to be full of cat intestines, adipose tissue, and strips of fur-covered skin. An intact left kidney and adipose tissue were found lodged in her throat just above her epiglottis. After a complete investigation, the cause of death was determined to be asphyxia by smothering due to animal tissue.
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Boghossian E, Tambuscio S, Sauvageau A. Nonchemical Suffocation Deaths in Forensic Setting: A 6-Year Retrospective Study of Environmental Suffocation, Smothering, Choking, and Traumatic/Positional Asphyxia. J Forensic Sci 2010; 55:646-51. [DOI: 10.1111/j.1556-4029.2010.01351.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cataneo AJM, Cataneo DC, Ruiz RL. Management of tracheobronchial foreign body in children. Pediatr Surg Int 2008; 24:151-6. [PMID: 17985139 DOI: 10.1007/s00383-007-2046-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2007] [Indexed: 11/28/2022]
Abstract
To study cases of foreign bodies (FB) in the tracheobronchial tree investigating the clinical and radiological FB characteristics, complications and endoscopic and surgical intervention. Medical and radiological records review of all FB aspiration cases treated at São Paulo State University Hospital over the last 30 years. One hundred and sixty-four FB cases were analyzed; 57% were male, 84% of these were under 16 years old. The most common clinical manifestations were coughing (68.3%) and choking (54.9%). The most common FBs were seeds (peanut, bean, maize) and also small metal or plastic objects. Radiography was normal in 21.3%, atelectasis was present in 40.9%, hyperinsufflation in 17.1% and the FB was radio-opaque in 20.7%. FB time in the bronchial tree varied from hours to years. The most serious complications, as fibroatelectasis and difficult resolution pneumonia, were caused by the long time that the FB remained in the bronchial tree. FB extraction was by endoscopy in 89% of cases, while 6% required surgical extraction or resection of destroyed part of lung, and 5% spontaneously eliminated the FB. There was no mortality in this series. Coughing and choking were the commonest clinical findings. Most FBs were dried seeds. Complications were due to delays in diagnosis, and most would not have existed if the doctor had given credence to the history. Radiography can be normal as most FBs are radiotransparent. FB extraction was by endoscopy, but a few cases required surgery and others were spontaneously eliminated.
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Affiliation(s)
- Antônio José Maria Cataneo
- Thoracic Surgery Discipline of the Surgery and Orthopedics Department, Botucatu School of Medicine, São Paulo State University, UNESP, 18.618-970, Botucatu, SP, Brazil.
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Kearney TE, Van Bebber SL, Hiatt PH, Olson KR. Protocols for pediatric poisonings from nontoxic substances: are they valid? Pediatr Emerg Care 2006; 22:215-21. [PMID: 16651908 DOI: 10.1097/01.pec.0000208179.56048.e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Most pediatric poisonings have favorable outcomes and are managed in the home by poison control centers utilizing protocols that deem products or substances as nontoxic. We sought to evaluate the validity of protocols for nontoxics. METHODS This is retrospective study in which poison control center case records within a statewide poison control center system during calendar year 2001 were searched for products or substances involved in a pediatric poisoning ingestion and identified in the poison control center nontoxic substance or product list. This was coupled with systematic literature search to ascertain if any significant medical outcomes were associated with ingestion of a nontoxic substance or product. RESULTS During the 1-year study period, 20,900 pediatric ingestions involving 46 different nontoxic substances or products were analyzed for significant outcomes. Only 6 cases (0.03%) had a potentially serious clinical effect requiring emergency hospital management. The literature search revealed 2326 ingestion cases of nontoxic products from 635,000 citations in 50 different databases. Of these, 28 cases (1.2%) described an effect, although none was described as significant. CONCLUSIONS Poisoning protocols for pediatric ingestions of substances or products we deemed as nontoxic were rarely associated with significant outcomes. However, non-dose-related potentially life-threatening effects are possible. Therefore, use of nontoxic protocols by other health care practitioners for telephone triage or by the public directly requires further study to be valid. Our study suggests that the term nontoxic is misleading and recommends that it be replaced with "minimally toxic" as a more appropriate term for identifying the lowest level of risk of toxicity from a substance or product.
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Affiliation(s)
- Thomas E Kearney
- California Poison Control System-San Francisco, San Francisco, CA 94143-1369, USA.
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Naylor JM. A clinical dilemma: to treat or not to treat in the presence of a pulmonary foreign body? PHYSIOTHERAPY RESEARCH INTERNATIONAL 2006; 10:232-4. [PMID: 16411619 DOI: 10.1002/pri.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Justine M Naylor
- Whitlam Joint Replacement Centre, Fairfield Hospital, Prairiewood, Sydney, Australia.
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Ozdemir C, Uzün I, Sam B. Childhood foreign body aspiration in Istanbul, Turkey. Forensic Sci Int 2005; 153:136-41. [PMID: 16139101 DOI: 10.1016/j.forsciint.2004.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2003] [Accepted: 08/24/2004] [Indexed: 11/24/2022]
Abstract
In this study, we present the data concerning 10 children (six boys, four girls) with a diagnosis of foreign body aspiration (FBA) amongst 19,951 cases that underwent autopsy between the years 1996-2002. Eight of the children were under 2 years old. All the incidents took place at home. One of the parents was in the company of the child at the time of incident. At least one of the risk factors was positive. Interestingly, all of the aspirated material was related to food except one. Only four cases had subpleural petechiae, whereas five of the seven subjects undergoing histopathological evaluation had edema, hyperemia or intra-alveolar fresh bleeding. The legal instructions, which regulate the standards of toy materials, came into force at the end of 2003. Even though the legal instructions regulating the size and consistency of toys are very important to prevent FBA, we believe that the education of the parents and carers in the prevention of food aspiration is of greater importance.
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Affiliation(s)
- Cağlar Ozdemir
- Department of Forensic Medicine, Faculty of Medicine, Erciyes University, 38039 Kayseri, Turkey.
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Pritt B, Harmon M, Schwartz M, Cooper K. A tale of three aspirations: foreign bodies in the airway. J Clin Pathol 2003; 56:791-4. [PMID: 14514789 PMCID: PMC1770072 DOI: 10.1136/jcp.56.10.791] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Tracheobronchial foreign body aspiration is a serious medical problem, with clinical manifestations ranging from acute asphyxiation to insidious lung damage, as demonstrated by the three presented cases. Patient 1 aspirated during dinner, emergency bronchoscopy retrieved pieces of food, and she fully recovered the following day. Patient 2 presented with recurrent pneumonia and a right lower lobe lung abscess. After right lower lobectomy, pathology revealed a foreign object in the right main stem bronchus, a peanut aspirated one year earlier. Patient 3 became unresponsive several days after spinal surgery. The differential diagnosis included myocardial infarction, stroke, and foreign body aspiration. The patient died and necropsy revealed a foreign body in the right main stem bronchus (cooked meat). Thus, foreign body aspiration is not always suspected clinically, and the pathologist may play an important role in making the diagnosis. Histological identification of the aspirated material may be necessary for definitive diagnosis. Therefore, sections of commonly aspirated foods are presented, together with a 10 year history of aspirated objects received by this institution's surgical pathology department.
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Affiliation(s)
- B Pritt
- Fletcher Allen Health Care, Department of Pathology, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA.
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