Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Retrospective Review of Tracheobronchial Foreign Bodies

기도 이물의 임상적 고찰

  • Son, Chang-Young (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Wee, Jeong-Ook (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Soo-Ock (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Oh, In-Jae (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Park, Chang-Min (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Kyu-Sik (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Kim, Yu-Il (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Lim, Sung-Chul (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Lim, Sang-Chul (Department of Otolaryngology & Head and Neck Surgery, Chonnam National University Medical School) ;
  • Kim, Young-Chul (Division of Pulmonology and Critical Care Medicine, Chonnam National University Medical School) ;
  • Park, Kyung-Ok (Internal Medicine, Seonam University Medical School)
  • 손창영 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 위정욱 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 김수옥 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 오인재 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 박창민 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 김규식 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 김유일 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 임성철 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 임상철 (전남대학교 의과대학 이비인후과학교실) ;
  • 김영철 (전남대학교 의과대학 호흡기 내과학교실) ;
  • 박경옥 (서남대학교 의과대학 내과학교실)
  • Received : 2005.01.17
  • Accepted : 2005.05.27
  • Published : 2005.06.30
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Abstract

Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

Keywords

References

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