This journal is
indexed in Scopus
Year 2016 Vol. 24 No 3
EXCHANGE OF EXPERIENCE
E.L. KALMYKOV1, Z.S. FAIZIEV2, H.Z. FAIZIEV3
FOREIGN BODIES OF TRACHEA AND BRONCHI
National Scientific Center of Transplantation of Human Organs and Tissues1,
Republican Center of Cardiovascular Surgery 2,
Avicenna Tajik State Medical University3,
The Republic of Tajikistan
Objectives. The analysis of the experience in airway (trachea and bronchi) foreign body removal by flexible bronchoscope.
Methods. Removal of foreign bodies from the respiratory tract (FBRT) was performed in 47 patients. There were 27 (57,5%) females, and 20 (42,5%) males. Age of patients ranged from 8 to 72 years. In 46 cases the patients underwent chest X-ray, in one case – CT.
Results. Foreign bodies were located: in the trachea – 2 cases (4,2%), in the right bronchial tree – 26 (55,3%), in the left bronchial tree – 19 (40,4%).
The early admission to the medical establishment with FBRT composed only 74,4% (n=35) out of 47 cases. The symptoms of an acute aspiration were asfollows: an acute respiratory failure in 35 (77,7%) cases, cough – 45 (100%), vomiting - 4 (8,8%), stridulous breathingr – 5 (11,1%), bronchospasm – 4 (11,1%).
In 95,8% (n = 45) of observations, foreign bodies localized in the bronchi on different levels. Radiography may be used to locate foreign bodies for removal. In 37 cases X-ray was able to determine the type of foreign body and its localization; in 10 cases radiography was failed to show the localization of the foreign body. The foreign bodies in the respiratory tract were: the needles – 22 (46,8%); nails / screws – 11 (23,4%); fish bones / animal bones – 8 (17%); tooth / denture (fragments) – 3 (6,3%); dental tool – 1 (2,1%); a thorn from a rose – 1 (2,1%); pistachio shells – 1 (2,1%). In 46 patients the foreign bodies were successfully removed by means of fibrobronchoscopy but in one case thoracotomy was performed.
Conclusion. In recent years the number of cases of foreign bodies in respiratory tract tends to increase. The various changes in the bronchial tree, the severity of the inflammatory response depended on FB length of stay in the respiratory tract can be detected by bronchoscopy. Bronchoscopic foreign body removal is considered to be a safe and effective procedure in 97,8% of cases.
- Huankang Z, Kuanlin X, Xiaolin H, Witt D. Comparison between tracheal foreign body and bronchial foreign body: a review of 1007 cases. Int J Pediatr Otorhinolaryngol. 2012 Dec;76(Is 12):1719-25. doi: 10.1016/j.ijporl.2012.08.008.
- Abakumov MM, Mironov AV, Kreimer VD. Diagnostika i udalenie inorodnykh tel trakhei i bronkhov [Diagnosis and removal of foreign bodies trachea and bronchi]. Vestn Khirurgii im II Grekova. 1998;157(1):70-73.
- Dong YC, Zhou GW, Bai C, Huang HD, Sun QY, Huang Y, et al. Removal of tracheobronchial foreign bodies in adults using a flexible bronchoscope: experience with 200 cases in China. Int Med. 2012;51 (18):2515-19. doi: 10.2169/internalmedicine.51.7672.
- Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, et al. Foreign body aspiration in children: experience from 2624 patients. Int J Pediatr Otorhinolaryngol. 2013 Oct;77(10):1683-8. doi: 10.1016/j.ijporl.2013.07.026.
- Nakhosteen JA. Tracheobronchial foreign bodies. Eur Respir J. 1994 Mar;7(3):429-30. doi: 10.1183/09031936.94.07030429.
- Lan RS. Non-asphyxiating tracheobronchial foreign bodies in adults. Eur Respir J. 1994 Mar;7(3):510-14.
- Debeljak A, Sorli J, Music E, Kecelj P. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974-1998. Eur Respir J. 1999 Oct;14(4):792-5.
- Karapolat S. Foreign-body aspiration in an adult. Can J Surg. 2008 Oct;51(5):411; author reply 411-2.
- Lin LJ, Lv LP, Wang YC, Zha XK, Tang F, Liu XM. The clinical features of foreign body aspiration into the lower airway in geriatric patients. Clin Interv Aging. 2014 Sep 24;9:1613-18. doi: 10.2147/CIA.S70924.
- Bain A, Barthos A, Hoffstein V, Batt J. Foreign-body aspiration in the adult: presentation and management. Can Respir J. 2013 Nov-Dec;20(Is 6):e98-9.
- Wu TH, Cheng YL, Tzao C, Chang H, Hsieh CM, Lee SC. Longstanding tracheobronchial foreign body in an adult. Respiratory Care. 2012;57(5):808-10. doi: 10.4187/respcare.01445.
- Kogure Y, Oki M, Saka H. Endobronchial foreign body removed by rigid bronchoscopy after 39 years. Interact Cardiovasc Thorac Surg. 2010 Dec;11(6):866-8. doi: 10.1510/icvts.2010.243097.
- Qureshi A, Behzadi A. Foreign-body aspiration in an adult. Can J Surg. 2008 Jun; 51(3):E69-E70.
- Rizk N, Gwely NE, Biron VL, Hamza U. Metallic hairpin inhalation: a healthcare problem facing young Muslim females. J Otolaryngol Head Neck Surg. 2014 Aug 2;43:21. doi: 10.1186/s40463-014-0021-y.
- Dikensoy O, Usalan C, Filiz A. Foreign body aspiration: clinical utility of flexible bronchoscopy. Postgrad Med J. 2002 Jul;78(921):399-403. doi: 10.1136/pmj.78.921.399.
734002, Republic of Tadzhikistan, Dushanbe,
ul. Mayakovskogo, d. 2,
Natsionalnyiy nauchnyiy tsentr
transplantatsii organov i tkaney cheloveka
i sotsialnoy zaschityi naseleniya Respubliki Tadzhikistan,
tel. 992 90 811-00-18,
Kalmykov Egan Leonidovich
Kalmykov E.L. PhD, a Deputy Director for Science of National Scientific Center of Transplantation of Human Organs and Tissues of the Ministry of Health and Social Protection of the Population of the Republic of Tadzhikistan.
Faiziev Z.S. PhD, a leading researcher of the Republican Center of Cardiovascular Surgery of the Ministry of Health and Social Protection of the Population of the Republic of Tadzhikistan.
Faiziev H.Z. A post-graduate student of the surgical diseases chair ¹2 of Avicenna Tajik State Medical University