RIGID BRONCHOSCOPY FOR TRACHEOBRONCHIAL FOREIGN BODIES IN CHILDREN: EXPERIENCE AT HOLY FAMILY HOSPITAL RAWALPINDI

Abstract

Background: Foreign body aspiration claims thousands of lives each year.1It is the fourth leading accidental cause of death under three years of age and the third cause of death under one year of age. The aim of the study was to evaluate the presentation and management of different types of foreign bodies in tracheobronchial tree in children.
Methods:This descriptive study carried out in the ENT department of Holy Family Hospital Rawalpindi, from January 2011 to June 2013. Children from emergency /OPD of ENT or pediatric unit with suspicion of foreign body aspiration were included in the study. Relevant history and demographic details were recorded. The findings of chest x-ray were also documented. All patients underwent rigid bronchoscopy under general anesthesia. Bronchoscopic findings with type and location of retrieved foreign body were noted down.
Results: A total of 168 cases went under bronchoscopy for the removal of foreign body. 69% were male. Mean age was 2.9 years. Cases which presented directly (direct cases) to us were 131(78%) and rest were referred from pediatric unit (referred cases). Total chest X-ray performed were 105(62.5%) though visible foreign body was present in only 16.19% cases. Paroxysm of cough was the main symptom (51.7%) and decreased breath sound was the main sign on presentation (88.6%). Foreign body was recovered in 94% of direct cases and 75.6% in referred cases. Ground nuts were the most common foreign body (71.52%) and the right bronchus was the most common location of foreign body lodgment (58.27%).
Conclusion: Rigid bronchoscopy is an effective procedure for the removal of foreign bodies in tracheobronchial tree in children.