Related Experiment Videos
[Pneumological aspects of bronchial foreign bodies in children. Experience with 100 cases]
Insights
Pediatric bronchial foreign bodies, often vegetable matter like peanuts, lead to delayed diagnosis and significant long-term respiratory complications. Early detection and intervention are crucial for preventing severe sequelae in children.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Otolaryngology
Context:
- Bronchial foreign body aspiration is a common pediatric emergency.
- A significant delay between inhalation and diagnosis is frequently observed.
- Vegetable matter, particularly peanuts, constitutes the majority of inhaled foreign bodies.
Purpose:
- To analyze the characteristics and diagnostic challenges of bronchial foreign bodies in children.
- To evaluate the short- and long-term pneumological sequelae following foreign body aspiration.
- To assess the efficacy of endoscopic removal and identify risk factors for complications.
Summary:
- This study reviewed 100 cases of pediatric bronchial foreign bodies, with 73% of children aged 6 months to 3 years.
- Delayed diagnosis ( >7 days) occurred in 70% of cases, impacting outcomes.
- Long-term sequelae included persistent radiological abnormalities (40%), perfusion (35%), and ventilation disorders (64%). Surgical intervention was required in 7 cases.
Impact:
- Highlights the critical need for prompt diagnosis and management of pediatric bronchial foreign bodies.
- Underscores the significant and persistent respiratory complications associated with delayed treatment.
- Provides valuable insights into the pathophysiology and long-term management of these conditions in children.
Abstract:
100 cases of bronchial foreign body seen over a period of 4 years represent 1.2% of the admissions of a paediatric pneumology unit; 73% of the children were aged between 6 months and 3 years. The foreign body was vegetable in 61% of cases (a peanut in 44% of cases). The time between the inhalation and the endoscopic diagnosis was greater than 7 days in 70% of cases and greater than 30 days in 37% of cases. Removal of the foreign body was possible in all but one case. In particular, the authors studied the pneumological implications of a foreign body: the value of a quantitative bacteriological study of the bronchial secretions, which was significant in 43% of cases, and detection of the sequelae by prospective clinical and functional surveillance with a follow-up of 3 to 24 months. After 6 months, persistent radiological abnormalities were found in 40% of cases, perfusion disorders were found in 35% and ventilation disorders were found in 64%. A surgical operation was performed in 7 cases: one case of bronchotomy for extraction of the foreign body and 6 cases of parenchymal excision, including 2 total pneumonectomy for a destroyed lung. These were no death. The pathophysiology of the complications of functional disorders and of dilatation of the bronchi is discussed in the context of the experience gained from this series.