Nandan Ruchira, Bajpai Minu, Yadav Devendra Kumar, Goel Prabudh
Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
J Indian Assoc Pediatr Surg. 2022 Jan-Feb;27(1):32-37. doi: 10.4103/jiaps.JIAPS_245_20. Epub 2022 Jan 11.
The extraction of smooth spherical objects is challenging as they are difficult to grasp within the jaws of the forceps and tend to slip distally.
The authors herein have shared their experience with the use of a Fogarty catheter (FC) for safe extraction of smooth and spherical "foreign body (FB) with a hole."
Report on pediatric cases ( = 4) of airway "FB with a hole" wherein the FC was used for their extraction. Mean age was 27.5 months (range: 17 months-39 months). The male: female ratio was 3:1. The technique of FB extraction with a FC has been described, including the principle of the technique, indications, and contra-indications, technical problems and troubleshooting.
The FB spectrum included a necklace bead ( = 2), nonnecklace bead ( = 1) and a fragmented end-piece of the housing of a ball-pen ( = 1). The locations of the FBs were right main bronchus ( = 1), secondary bronchus on the right ( = 1), and in the left main bronchus ( = 2). Successful removal of FB with use of FC during rigid broncoscopy was possible. The bead had to be rotated in = 2 patients to align the hole with the FC. Problems associated with threading the hole and disimpaction of the FB have been highlighted. No complications were observed. The advantages and limitation of the technique have been discussed.
The use of FC with the described technique offers a safe, effective and reproducible method for removal of airway "FB with a hole" in a controlled environment while minimizing the possibility of iatrogenic injury to the wall of the surrounding airways.
光滑球形物体的取出具有挑战性,因为它们很难用镊子夹住,并且往往会向远端滑动。
本文作者分享了使用Fogarty导管(FC)安全取出带有孔洞的光滑球形“异物(FB)”的经验。
报告4例气道“带孔异物”的儿科病例,其中使用FC进行取出。平均年龄为27.5个月(范围:17个月至39个月)。男女比例为3:1。描述了使用FC取出异物的技术,包括该技术的原理、适应证和禁忌证、技术问题及故障排除。
异物谱包括项链珠子(2例)、非项链珠子(1例)和圆珠笔笔套的碎片端(1例)。异物位置分别为右主支气管(1例)、右叶支气管(1例)和左主支气管(2例)。在硬质支气管镜检查期间使用FC成功取出异物。2例患者需要旋转珠子以使孔洞与FC对齐。强调了与孔洞穿线和异物取出相关的问题。未观察到并发症。讨论了该技术的优点和局限性。
使用FC结合所述技术为在可控环境中取出气道“带孔异物”提供了一种安全、有效且可重复的方法,同时将对周围气道壁造成医源性损伤的可能性降至最低。