[Rigid endoscopy and laryngo-tracheo-bronchial foreign bodies in children: observations apropos of 200 endoscopies conducted in a tropical setting].

Between 1986 and 1998, 200 rigid bronchoscopic procedures under general anesthesia were carried out at the Principal Hospital in Dakar, Senegal for foreign body extraction from the distal airways of 194 children. For the study period, the incidence of this accident was 3.7 p. 1000. Sixty-three percent of patients were male and 77 p. 100 were under 4 years of age. Most patients (69 p. 100) were examined within 48 hours after the accident. Examination of clinical records showed that aspiration was mentioned during anamnesis in only 56 p. 100 of cases. Persistent coughing (80 p. 100) and mild dyspnea (70 p. 100) were the most common symptoms. Auscultation of the lungs was negative in 25 p. 100 of cases and anterior x-ray of the neck and chest were normal or poorly informative in 59 p. 100. In 154 of the 200 procedures, extraction of the foreign body was successful from the trachea in 35 p. 100 of cases, the larynx in 13 p. 100, the right main stem bronchus in 31 p. 100 and the left main stem bronchus in 21 p. 100. In the remaining 46 cases, extraction was unsuccessful. The most frequent foreign body was a peanut. No deaths occurred in this series but cardiac arrest was observed in 6 patients during or immediately after endoscopy. This experience confirms the indication for immediate rigid bronchoscopy in cases involving aspiration or persistent respiratory symptoms. The high incidence of this accident suggests that information campaigns should be undertaken in health care facilities, households, and schools.