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Tracheobronchial foreign bodies. A persistent problem in pediatric patients
H Puhakka1, E Svedström, P Kero
1Department of Otolaryngology, University Central Hospital, Turku, Finland.
Insights
Bronchoscopic extraction successfully removed foreign bodies from 98% of children, with peanuts being the most common object. Early intervention is crucial for managing airway foreign bodies in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Bronchoscopy
- Foreign Body Aspiration
Background:
- Foreign body aspiration into the tracheobronchial tree is a common pediatric emergency.
- Early diagnosis and intervention are critical to prevent complications.
Purpose of the Study:
- To evaluate the efficacy and outcomes of foreign body extraction from the tracheobronchial tree in children.
- To identify common foreign bodies and their locations.
Main Methods:
- Retrospective analysis of 83 children undergoing foreign body extraction via bronchoscopy.
- Data collected included patient demographics, foreign body characteristics, location, and procedural outcomes.
Main Results:
- Extraction was successful in 81 children (98%).
- Peanuts accounted for 30% of foreign bodies.
- 49% of foreign bodies were located in the right bronchial tree.
Conclusions:
- Bronchoscopic extraction is a safe and highly effective procedure for pediatric tracheobronchial foreign bodies.
- Prompt bronchoscopy is recommended for children with persistent stridor or cough unresponsive to antibiotics.
Abstract:
Extraction of a foreign body from the tracheobronchial tree was accomplished for 83 children. The mean age was 1 year 9 months for the 27 girls and 3 years 1 month for the 56 boys; 46 children (55%) were younger than 2 years of age. Sixteen (19%) of the foreign bodies were radiopaque, and 35 (42%) were either verified or suspected radiologically before endoscopy. Forty-one foreign bodies (49%) were situated in the right bronchial tree. Extraction was successful in 81 children (98%) and was performed on 50 children (60%) during the first 24 hours. Twenty-five (30%) of the foreign bodies were peanuts. Three children experienced a residual foreign body, without serious complications. We believe that an open tube bronchoscopy should be performed whenever abnormal stridor or cough is observed in a healthy child and when appropriate antibiotic therapy is unsuccessful.