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Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children.

Abstract：

OBJECTIVE:This study sought to summarize the experience of diagnosis and treatment of tracheobronchial foreign bodies in children to effectively reduce complications and mortality. METHODS:The medical records of 1024 pediatric patients admitted to our hospital from January 1997 to September 2011 and diagnosed with clinically suspected tracheobronchial foreign body aspiration were retrospectively analyzed. RESULTS:Of the 1024 children patients, 674 were boys (65.8%) and 350 girls (34.2%). Two died of respiratory and circulatory failure (foreign bodies detected upon bronchoscopy but not retrieved) before surgery, 65 patients underwent direct bronchoscopic removal of foreign bodies due to their critical status, and 957 received chest radiographs and chest fluoroscopy or multidetector spiral computed tomographic scans (941 positive). Foreign bodies were expectorated before surgery in 3 cases. There were 953 cases of bronchoscopically proven airway foreign body aspiration, with a diagnostic accuracy of 94.5%. Ninety-eight foreign bodies were lodged in the main bronchus and/or bilateral bronchi, 506 in the right main bronchus, and 349 in the left main bronchus. Atelectasis was noted in 42 patients, including 11 with pulmonary consolidation, whose lungs were re-expanded by endobronchial lavage and sputum aspiration. In 3 patients with bronchiectasis, conservative treatment following foreign body removal was followed by no improvement, and pulmonary lobectomy was performed. Foreign bodies were successfully extracted at the first bronchoscopic attempt in 948 cases, accounting for 99.7% of the total. However, 3 patients had to undergo another bronchoscopy to remove the foreign bodies. The most common types of foreign bodies were peanuts, melon seeds, and beans. CONCLUSIONS:Timely accurate diagnosis and treatment of tracheobronchial foreign bodies in children can avoid delay in treatment and effectively reduce complications and mortality.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Gang W,Zhengxia P,Hongbo L,Yonggang L,Jiangtao D,Shengde W,Chun W

doi

10.1016/j.jpedsurg.2012.07.036

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

2004-10

issue

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(12)00549-0

journal_volume

pub_type

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Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children.