Objectives: This retrospective study aimed to determine the frequency and management of inhaled
radiopaque foreign bodies (FB) among a population of patients of age group of 10-20 years.
Patients & Methods: The study design included verification of data extracted from patients' files
admitted for retrieval of inhaled radiopaque FB. Inclusion criteria included age range; 10-20 years and
the files must contain all needed data and patients were managed according to a protocol including:
rigid bronchoscopy (RB) under general anesthesia that was repeated 1-3 days thereafter if the first trial
failed. If recurrent failure occurred, a trial with fiberoptic bronchoscope (FOB) was done, but in case of
failure thoracotomy and bronchotomy was performed.
Results: The study included 321 patients; 274 females and 47 males with mean age of 13.2±1.9 years
and 292 patients were early presenters and 29 were late presenters. Females are significantly frequent
among early presenters compared to males. Only 57 patients presented with either dry irritating cough
or bloody tinged sputum, while 264 patients were asymptomatic with non-significant difference
between males and females. Left bronchial tree FB were detected in 167 patients (52%), 137 FB
(37.7%) were in right bronchial tree, while 33 FB (10.3%) were in the trachea with significant
difference between males and females as regards the location of the inhaled FB. Seventeen patients of
early presenters had spontaneous FB retrieval. A total of 216 patients underwent successful first trial
RB, 58 patients had successful redo RB, 7 patients had successful FOB and 23 patients underwent
thoracotomy. A total of 422 bronchoscopic trials were conducted; 392 trials using RB and 30 using
FOB. Considering shift to thoracotomy as a failure of bronchoscopic retrieval, bronchoscopy provided
a total success rate in studied patients' population of 92.8%; 90.7% for RB and 23.3% for FOB. Mean
theater time for bronchoscopy was 33 minutes and mean hospital stay was 2.1 days, while mean postthoracotomy
hospital stay was 6.1 days. Eleven patients developed complications after bronchoscopy
for a complication rate of 2.6% for bronchoscopic trials and 3.6% for patients.
Conclusion: inhaled radiopaque FB is not uncommon event in patients of age group 10-20 years and
the applied management protocol provided bronchoscopic retrieval of FB with a total success rate of
92.8% and minimal complications.
Keywords: Inhaled radiopaque foreign body, Bronchoscopy, Thoracotomy, Children, Adolescents |
