Ghosh Debasish, Mitra Ritabrata, Mondal Sripurna, Kumar Soutrik, Sengupta Arunabha
Institute of OtoRhinoLaryngology and Head Neck Surgery, IPGME and R, 244 A.J.C. Bose Road, Kolkata, 700020 West Bengal India.
Department of Respiratory Medicine, IPGME and R, Kolkata, 700020 India.
Indian J Otolaryngol Head Neck Surg. 2023 Sep;75(3):1533-1541. doi: 10.1007/s12070-023-03628-1. Epub 2023 Mar 15.
Foreign body aspiration is potentially life-threatening in paediatric age group. Early recognition and emergency intervention by Rigid bronchoscopy is life-saving. To highlight various difficulties in emergency paediatric bronchoscopy and discuss our experience in 138 patients. < 12 years children with suspected foreign body aspiration were included. Data of 138 patients < 12 years of age were studied. The most common foreign body found was peanut and organic foreign bodies constituted of total foreign bodies removed. Choking, Cough and sudden onset breathlessness were common symptoms. Tachypnoea, asymmetric breath sound, rhonchi, stridor, reduced chest movements were common signs. Obstructive emphysema was commonest radiological findings. Majority of the patients were discharged within 72 h & only two patients expired. History, clinical and radiological findings are highly indicative of foreign body in the airway. Inspite of being a high risk procedure, Rigid bronchoscopy when performed with necessary expertise,trained anaesthesia team and a paediatric ICU, saves majority of lives of children with tracheobronchial foreign bodies.
异物吸入在儿童年龄组中具有潜在的生命威胁。通过硬质支气管镜进行早期识别和紧急干预可挽救生命。为了突出小儿急诊支气管镜检查中的各种困难并讨论我们在138例患者中的经验。纳入了年龄小于12岁疑似异物吸入的儿童。研究了138例12岁以下患者的数据。发现的最常见异物是花生,取出的异物中有机异物占总数。窒息、咳嗽和突发呼吸困难是常见症状。呼吸急促、呼吸音不对称、哮鸣音、喘鸣、胸部活动减少是常见体征。阻塞性肺气肿是最常见的影像学表现。大多数患者在72小时内出院,仅有2例患者死亡。病史、临床和影像学表现高度提示气道内有异物。尽管硬质支气管镜检查是一项高风险操作,但在具备必要专业知识、训练有素的麻醉团队和儿科重症监护病房的情况下进行,可挽救大多数气管支气管异物患儿的生命。