Management of tracheobronchial foreign bodies: a retrospective and prospective study

(1) To study the presenting complaints or complaints suggestive of foreign bodies in the tracheobronchial tract. (2) To study the clinical findings. (3) To study the correlation between clinical and radiological findings. (4) To study different types of foreign bodies. (5) To study the complications caused by foreign bodies. A total of 115 patients presenting with foreign body aspiration in the tracheobronchial tract were included in the study. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted. Foreign bodies in trachea and bronchus were removed by rigid bronchoscopy under general anaesthesia. Jackson rigid bronchoscope with a fibre optic light source and venturi technique anaesthesia was used. In the present study, foreign body aspiration was found to be maximum in the 1-3 year old age group. The average time lapse between aspiration of symptoms and presentation was found to be 1-3 days. Positive history was given in only 68% cases. Cough and breathlessness were the most common presenting symptoms. The commonest clinical signs were decreased chest movement and air entry on the affected side. Collapse of the affected side was the most common radiological finding. The commonest site of impaction was the right main bronchus. Majority of the foreign bodies were vegetative, peanut being the most common. The commonest complication following foreign body aspiration was atelectasis of the affected lung. Successful removal of foreign bodies was possible in all the patients. In paediatric respiratory compromise, the presence of unilateral diminished breath sounds, a pathological chest X-ray and a clinical triad of cough, choking and wheezing, is a powerful indicator of tracheobronchial foreign body aspiration. Since no single or combined variables can predict foreign body aspiration with full certainty, bronchoscopic exploration must be performed if tracheobronchial foreign body aspiration is suspected.