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Foreign-body pulmonary embolism
1IWK Children's Hospital, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract:
The minimal incidence of pulmonary foreign-body embolism in a general pediatric pathology experience was ascertained by reviewing autopsy records, and the true incidence of pulmonary foreign-body embolism was determined by studying lung sections from 64 autopsies of patients who had undergone cardiac procedures. Seventeen cases of embolism were reported from 370 autopsies, an incidence of 4.6%. The true incidence of pulmonary foreign-body embolism was found to be 21.9% in the cardiac surgical autopsies and the minimal incidence was 5.1% in patients who had other types of surgery. No patients other than those having surgical procedures had embolism. Hair was found to be the embolic material in 35% of cases. Embolic lesions were characterized, staged, and correlated with clinical data. The pathogenesis of this condition is unclear, but it probably involves contamination of surgical materials with particulate matter.
Insights
Pulmonary foreign-body embolism is rare in general pediatric autopsies but significantly higher after cardiac surgery. Hair is a common embolic material, likely from surgical contamination.
Area of Science:
- Pathology
- Pediatric Pathology
- Cardiovascular Surgery
Background:
- Pulmonary foreign-body embolism (PFBE) is a rare complication.
- Its incidence in pediatric populations, especially post-cardiac procedures, is not well-defined.
Purpose of the Study:
- To determine the minimal and true incidence of PFBE in pediatric autopsies.
- To investigate the association between PFBE and cardiac surgical procedures.
Main Methods:
- Review of autopsy records from 370 pediatric cases.
- Microscopic examination of lung sections from 64 autopsies of patients who underwent cardiac procedures.
- Characterization and staging of embolic lesions and correlation with clinical data.
Main Results:
- A minimal incidence of 4.6% PFBE was observed in general pediatric autopsies.
- The true incidence of PFBE in cardiac surgical autopsies was 21.9%.
- A minimal incidence of 5.1% PFBE was found in patients with other surgeries; no embolism occurred in non-surgical patients. Hair was the embolic material in 35% of cases.
Conclusions:
- PFBE is significantly more prevalent in pediatric patients undergoing cardiac surgery.
- Surgical contamination with particulate matter, such as hair, is a probable cause.
- Further research into the pathogenesis and prevention of PFBE is warranted.