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[Foreign body in tracheobronchial diagnosed as pneumonia from children]
Chunying Feng1, Ming Liu, Fang Liu
1Department of Otolaryngology, the Second Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, 518020, China. Fengcy89@sina.com.cn
Insights
Tracheobronchial foreign bodies are often misdiagnosed as pneumonia, particularly in young children. Early diagnosis and removal via rigid bronchoscopy are crucial for effective treatment and preventing complications.
Area of Science:
- Pediatric Pulmonology
- Bronchoscopy Techniques
- Foreign Body Aspiration
Context:
- Tracheobronchial foreign bodies (TBFB) pose diagnostic challenges, frequently mimicking pneumonia.
- Children under two years old represent a significant risk group for TBFB.
- Peanuts are the most common aspirated foreign body in this pediatric population.
Purpose:
- To enhance the diagnostic accuracy and therapeutic outcomes for pediatric patients with TBFB.
- To review and summarize clinical experience with TBFB diagnosis and management.
- To reduce the incidence of misdiagnosis of TBFB as pneumonia.
Summary:
- A retrospective review of 172 pediatric TBFB cases from 1995-2005, with 67 initially diagnosed as pneumonia.
- Rigid bronchoscopy under general anesthesia was the primary intervention, achieving a 94% first-time removal success rate.
- No fatalities or tracheotomies were required; anesthesia was the main cause of initial removal failure.
Impact:
- Highlights the increasing trend of TBFB and the need for improved diagnostic strategies.
- Emphasizes the efficacy and safety of rigid bronchoscopy for TBFB removal in children.
- Aims to decrease diagnostic errors and improve patient management for TBFB.
Objective:
To improve the effects of diagnosis and therapy in patients with tracheobronchial foreign body who were diagnosed as pneumonia and to summarize the experience.
Method:
Foreign bodies in the trachea and bronchi in one hundred and seventy-two children were removed in our hospital from 1995. 2 to 2005. 2, of them 67 cases were diagnosed as pneumonia.
Result:
Our experience showed that the foreign body in tracheobronchial had an increasing tendency in recent years, and it had a descendant tendency that it be diagnosed as pneumonia. The time of the patients suffered from foreign bodies was from 5 days to 8 months, and the children under 2 years accounted for 80.6%. The most common foreign body was peanuts, accounting for 70.4%. All the foreign bodies were removed by rigid bronchoscopy. The successful rate of removal at first time was 63 cases, accounting for 94%. The reason of failure at first time was anesthesia (2 cases). There was no case of death. No cases underwent tracheotomy.
Conclusion:
The foreign body in tracheobronchial can be easily diagnosed as pneumonia. We should reduce the rate of erroneous diagnosis. Rigid bronchoscopy for removing foreign bodies under general anesthesia is still the main measure at present.
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