Clinical Features of Tracheobronchial Foreign Bodies in Adults according to the Risk of Aspiration.
10.4046/trd.2008.64.5.356
- Author:
Yee Hyung KIM
1
;
Cheon Woong CHOI
;
Hye Sook CHOI
;
Myung Jae PARK
;
Hong Mo KANG
;
Jee Hong YOO
Author Information
1. Department of Pulmonary and Critical Care Medicine, East-West Neo Medical Center, Korea. honglung@chol.com
- Publication Type:Original Article
- Keywords:
Foreign body;
Aspiration;
Flexible bronchoscope
- MeSH:
Adult;
Alligators and Crocodiles;
Biopsy;
Bronchoscopes;
Chest Pain;
Cough;
Dyspnea;
Eating;
Fever;
Foreign Bodies;
Hemoptysis;
Humans;
Jaw;
Medical Records;
Pneumonia;
Pulmonary Atelectasis;
Respiratory Sounds;
Retrospective Studies;
Surgical Instruments;
Thorax;
Tooth
- From:Tuberculosis and Respiratory Diseases
2008;64(5):356-361
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. METHODS: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. RESULTS: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. CONCLUSION: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.
