scholarly journals Foreign Body of the Right Main Bronchus with Tracheal Perforation (Case Report)

2019 ◽  
Vol 4 (2) ◽  
pp. 148-151
Author(s):  
V. N. Stalmahovich ◽  
E. V. Sapukhin ◽  
A. P. Dmitrienko ◽  
A. A. Dukov
Keyword(s):  
Foreign Body ◽  
Main Bronchus ◽  
Lung Ventilation ◽  
Tracheobronchial Tree ◽  
Endoscopic Examination ◽  
Terminal Condition ◽  
Medical Institution ◽  
Emergency Thoracotomy ◽  
Left Wall ◽  
The Right

The article describes a rare case of a foreign body removal from the tracheobronchial tree of a child. In the acute period of aspiration, the girl developed severe hypoxia, a terminal condition caused by the standing of a foreign body in the infraglottic space, a spasm of the vocal cords and obstruction of the lumen of the respiratory tract. In emergency tracheal intubation in a medical institution at the place of residence, the foreign body was moved more distally, which allowed to restore lung ventilation, stabilize the child’s condition and transport her to a specialized medical institution where X-ray and endoscopic examination were performed. It was found that the one-year-old patient had a screw cap tightly wedged into the lumen of the right main bronchus, and the screw’s opposite sharp end punched the left wall of the trachea above its carina. There was a potentially high risk of perforation of the main vessels of the mediastinum with massive bleeding and an unfavorable outcome. Endoscopic removal of a foreign body was technically impossible due to the peculiarity of its transverse arrangement and perforation of the wall, which served as an indication for emergency thoracotomy. A longitudinal sternotomy was performed, providing good access to the distal trachea, the main bronchi and the great vessels. Then we performed transverse bronchotomy in the initial part of the right main bronchus on half of its circumference, removed the foreign body, sutured the wall of the bronchus. The length of the extracted self-drilling screw was 35 millimeters. Postoperative early and late periods went without complications. At follow-up, mucosal surface of the right main bronchus was pink, the vascular pattern was visible, the bronchus was freely passable, not deformed.

scholarly journals Broken metallic tracheostomy tube migrating into the tracheobronchial tree

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Ratna Priya ◽  
Sheetal Shelke ◽  
Kartik Krishnan
Keyword(s):  
Foreign Body ◽  
Tracheostomy Tube ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Life Saving ◽  
Wear And Tear ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Periodic Replacement

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.

scholarly journals Flexible bronchoscopy in foreign body removal in the pediatric population: A Systematic Review

2021 ◽  
Author(s):  
Anastasios-Panagiotis Chantzaras ◽  
Panagiota Panagiotou ◽  
Spyridon Karageorgos ◽  
Konstantinos Douros
Keyword(s):  
Systematic Review ◽  
Foreign Body ◽  
Pediatric Population ◽  
Bronchial Tree ◽  
Tracheobronchial Tree ◽  
Flexible Bronchoscopy ◽  
Safe Alternative ◽  
Gold Standard Method ◽  
Foreign Body Removal ◽  
The Right

Background: Foreign body aspiration (FBA) in the tracheobronchial tree is a common problem in the pediatric population. Rigid bronchoscopic procedure is currently the gold standard method for treatment in pediatric patients, whereas recent reports present flexible bronchoscopy as an alternative method. The aim of this study was to summarize all available evidence regarding the application and the success rate of flexible bronchoscopy in foreign body (FB) removal. Methods: Systematic review of the use of flexible bronchoscopy as the first-line treatment in FBA cases in PubMed from 2001 to 2021. Results: Out of 243 citations, 23 studies were included on the use of flexible bronchoscopic procedure as a treatment of choice in 2,587 children with FBA. The FBs were successfully removed in 2,254/2,587 (87.1%) patients with a low complication rate. The majority of FBs retrieved were organic materials 1,073/1,370 (78.3%), and they were most commonly lodged in the right bronchial tree 708/1,401 (50.5%). General anesthesia was applied in most studies (14/23) before proceeding to a flexible bronchoscopy and laryngeal mask airways (LMAs) were mostly used (10/23 studies) to secure the airway during the procedure. Ancillary equipment, usually forceps 1,544/1808 (85.4%) assisted in the FB retrieval. Conclusion: The use of flexible bronchoscopy is shown to be a feasible and safe alternative therapeutic procedure in FBA cases. There is a need for development of extraction equipment and techniques to assist the procedure. Finally, future studies focusing on the comparison between clinical outcomes of flexible and rigid bronchoscopies are necessary.

scholarly journals BEAD; A DIFFICULT TRACHEOBRONCHIAL FOREIGN BODY TO RETRIEVE; BRONCHOSCOPIST PERSPECTIVE.

1969 ◽  
Vol 4 (1) ◽  
pp. 404-408
Author(s):  
ADNAN ◽  
M. RIAZ AFRIDI ◽  
M. SAEED ◽  
METHEW K JOSEPH ◽  
M. JAVAID ◽  
...  
Keyword(s):  
Foreign Body ◽  
Fiber Optic ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Clinical Findings ◽  
Western World ◽  
Left Main ◽  
Female Age ◽  
Tracheobronchial Foreign Body ◽  
Tracheobroncheal Tree

To know the efficacy of different instruments in retrieval of bead from tracheobronchial tree.BACKGROUND: Bead is uncommon object in western world and therefore rarely recorded as aforeign body in tracheobronchial tree. No specific instrument being named for its retrieval. Our studyfocuses on different instruments we used and its outcome.MATERIAL AND METHODS: This was retrospective study of foreign body bead impaction intracheobronchial tree. All patients subjected to bronchoscopy with definite clinical findings of beadimpaction on radiology or bronchoscopic examination were recorded, with different instruments used. Inall cases Karlstorz rigid bronchoscopes of size 3.0 to 5.0 with fiber optic light used. Long bronchoscopicscrew forceps, malleable forceps. Large nasal killian forceps was used after tracheostomy in some cases.Study period: 1st January 2008 to December 2012.Site: ENT A unit Hayatabad Medical Complex Peshawar.RESULTS: In our study of 3 years 32 cases were recorded with bead impaction in tracheobronchealtree. 21(65.62%) were male and 11 (34.37%) female. Age ranges below 1 year was 1 (3%) case,between lyear and 2 years 6 (18.75%) cases, 2 years to 3 years 21(65.62%) and 3 years and above 4(12.5%) cases recorded. 21(65.62%) beads were retrieved with malleable forceps, 8 (25%) with longscrew forceps, 1 (3%) after tracheostomy with long killan nasal forceps and 2 (6.25%) impacted beadswere referred to cardiothoracic department for thoracotomy. 3 (9.37%) beads were impacted in maintrachea, 19 (59.53%) in right main bronchus and 10 (31.25%) in left main bronchus.CONCLUSION: Bead is one of the difficult foreign body tracheobroncheal tree and needs specialinstruments for its removal.KEY WORDS: Beeds, Boronchoscopy,

Lung Abscess Secondary to Esophageal Foreign Body

1978 ◽  
Vol 87 (4) ◽  
pp. 568-570 ◽  
Author(s):  
B. C. Okafor
Keyword(s):  
Foreign Body ◽  
Main Bronchus ◽  
External Pressure ◽  
Lung Abscess ◽  
Esophageal Foreign Body ◽  
Esophageal Lumen ◽  
Long Period ◽  
The Right

The case reported here is one in which a foreign body in the esophagus resulted in a right lung abscess. Interest here centers on the unusual nature of the foreign body and the extraordinarily long period it was allowed to remain in the esophageal lumen even though it was producing symptoms throughout this period. The various factors involved are discussed, also the somewhat peculiar fact that the lung abscess was on the right, resulting from external pressure on the right main bronchus.

scholarly journals Successful one-lung ventilation by blocking the right intermediate bronchus in a 7-year-old child: a case report

2019 ◽  
Vol 47 (6) ◽  
pp. 2740-2745
Author(s):  
Seung Youp Baek ◽  
Jin Hwan Kim ◽  
Goo Kim ◽  
Jin Ho Choi ◽  
Chang Young Jeong ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Main Bronchus ◽  
Left Lung ◽  
Lung Ventilation ◽  
Surgical Excision ◽  
One Lung Ventilation ◽  
Lower Lung ◽  
Endobronchial Blocker ◽  
Surgical Field ◽  
The Right

A 7-year-old child underwent surgical excision of a benign mesothelioma of the pleura near the right lower lung. Although insertion of a wire-reinforced endotracheal tube through the left main bronchus was attempted for one-lung ventilation to secure the surgical field of view, the attempt failed. Therefore, an endotracheal tube was inserted into the trachea, and an Arndt endobronchial blocker (Cook Medical, Bloomington, IN, USA) was placed in the right intermediate bronchus under bronchoscopic guidance to selectively block the right lower and middle lobes. The surgery was performed while ventilating the right upper lobe and left lung, and no specific intraoperative adverse events occurred.

scholarly journals Structural and functional alterations of the tracheobronchial tree after left upper pulmonary lobectomy for lung cancer

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Qingtao Gu ◽  
Shouliang Qi ◽  
Yong Yue ◽  
Jing Shen ◽  
Baihua Zhang ◽  
...  
Keyword(s):  
Flow Rate ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Sectional Area ◽  
Pulmonary Lobectomy ◽  
Airflow Velocity ◽  
Cross Sectional ◽  
Lobar Bronchus ◽  
Cfd Method ◽  
The Right

Abstract Background Pulmonary lobectomy has been a well-established curative treatment method for localized lung cancer. After left upper pulmonary lobectomy, the upward displacement of remaining lower lobe causes the distortion or kink of bronchus, which is associated with intractable cough and breathless. However, the quantitative study on structural and functional alterations of the tracheobronchial tree after lobectomy has not been reported. We sought to investigate these alterations using CT imaging analysis and computational fluid dynamics (CFD) method. Methods Both preoperative and postoperative CT images of 18 patients who underwent left upper pulmonary lobectomy are collected. After the tracheobronchial tree models are extracted, the angles between trachea and bronchi, the surface area and volume of the tree, and the cross-sectional area of left lower lobar bronchus are investigated. CFD method is further used to describe the airflow characteristics by the wall pressure, airflow velocity, lobar flow rate, etc. Results It is found that the angle between the trachea and the right main bronchus increases after operation, but the angle with the left main bronchus decreases. No significant alteration is observed for the surface area or volume of the tree between pre-operation and post-operation. After left upper pulmonary lobectomy, the cross-sectional area of left lower lobar bronchus is reduced for most of the patients (15/18) by 15–75%, especially for 4 patients by more than 50%. The wall pressure, airflow velocity and pressure drop significantly increase after the operation. The flow rate to the right lung increases significantly by 2–30% (but there is no significant difference between each lobe), and the flow rate to the left lung drops accordingly. Many vortices are found in various places with severe distortions. Conclusions The favorable and unfavorable adaptive alterations of tracheobronchial tree will occur after left upper pulmonary lobectomy, and these alterations can be clarified through CT imaging and CFD analysis. The severe distortions at left lower lobar bronchus might exacerbate postoperative shortness of breath.

Foreign Bodies in the Larynx and Tracheobronchial Tree in Children

1980 ◽  
Vol 89 (5) ◽  
pp. 434-436 ◽  
Author(s):  
Bruce F. Rothmann ◽  
Clifford R. Boeckman
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Tracheobronchial Tree ◽  
Female Ratio ◽  
Foreign Objects ◽  
Left Bronchus ◽  
Male Female Ratio ◽  
Opaque Object ◽  
The Right ◽  
Trachea And Bronchi

In a study of 225 patients with foreign bodies in the larynx, trachea and bronchi, 77 % were 36 months of age or less. The male-female ratio was 2:1. Food or food derivatives were the causative agent in 70% of the cases, with 38% due to a portion of nut. The foreign body involved the right and left bronchus with equal frequency. A choking episode followed by an audible wheeze (55 %) was the most common presenting complaint. Obstructive emphysema was demonstrated in 60 % and was best demonstrated by inspiration-expiration chest roentgenograms or fluoroscopy. A radio-opaque object was seen in 13 %. Two hundred ten foreign objects (93 %) were removed by endoscopy. Four patients required pulmonary resection for bronchiectasis and in three patients bronchotomy was performed. Five patients expelled the foreign body spontaneously, two patients were transferred to another hospital, and one foreign body was not recovered. There was no mortality.

scholarly journals Foreign body extraction through the rigid bronchoscopy

2011 ◽  
Vol 68 (10) ◽  
pp. 878-880 ◽  
Author(s):  
Stanko Mrvic ◽  
Milos Milosavljevic ◽  
Dragan Stojkovic ◽  
Slobodan Milisavljevic ◽  
Dragce Radovanovic ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pediatric Population ◽  
Tracheobronchial Tree ◽  
Rigid Bronchoscopy ◽  
Middle Lobe ◽  
Lobe Bronchus ◽  
Segmental Bronchus ◽  
Foreign Body Extraction ◽  
The Right ◽  
High Level

Introduction. Foreign body aspiration into tracheobronchial tree represents an urgent condition at high level of risk. Etiology is different, and this condition is typical for all ages with highest incidence in pediatric population. Case report. A successful foreign body removal (partial denture) in a 34-year old man was presented. Radiography and computerized tomography of the chest showed a foreign body localized at the level of the right bronchus including the right middle lobe bronchus. By the use of rigid bronchoscopy, a foreign body was visualized and mobilized from the segmental bronchus in the first act, and then completely extracted. Conclusion. Efficient diagnostics and extraction are imperative for the aspirated foreign body preventing life-threatening complications.

scholarly journals Tracheobronchial foreign body aspiration: A 13-year retrospective analysis

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 69-74
Author(s):  
Danijela Dragicevic ◽  
Ljiljana Jovancevic ◽  
Rajko Jovic ◽  
Ljiljana Vlaski ◽  
Bojan Bozic
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Main Bronchus ◽  
Age Groups ◽  
Rigid Bronchoscopy ◽  
Foreign Body Aspiration ◽  
Radiological Findings ◽  
Tracheobronchial Foreign Body ◽  
The Moment ◽  
The Right

Introduction. Foreign body aspiration into the respiratory tract remains a diagnostic and therapeutic challenge in clinical practice, especially in young children, who are the most frequently affected age group. The aim of this study was to present the results of treating the patients with foreign body aspiration in all age groups. Material and Methods. The medical and radiological records of 64 patients with confirmed foreign body out of 146 patients with suspected foreign body aspiration were retrospectively analyzed during the period of 13 years (from 2001 to 2013). Results. A foreign body was found in 64 (44%) of the 146 patients of all age groups with suspected foreign body aspiration. The patients? age ranged between 11 months and 80 years. There were 84% children and 16% adults, and 63% of patients were male. Time between the moment of aspiration and admission to the Department ranged between 0.5 hours and 14 days, with majority of patients (70%) being admitted during the first 24 hour. History of respiratory drama was present in 92% of patients. Physical and radiological findings were positive in 66% and 47% of patients, rescpectively. Organic vegetable foreign bodies accounted for 75% of all cases, and they were most frequently found in the right main bronchus (63%). All foreign bodies were successfully extracted by rigid bronchoscopy, without serious complications and fatal outcomes. Conclusion. Bronchoscopy should be performed in any case of suspected foreign body aspiration, even if clinical and radiological findings are normal, in order to avoid serious and possible life-threatening complications. More should be done to raise awareness of this potentially preventable condition.

scholarly journals Clinical and pathophysiological features of traumatic stenosis of the right main bronchus: Case report

2007 ◽  
Vol 135 (11-12) ◽  
pp. 666-668
Author(s):  
Vojkan Stanic ◽  
Tatjana Vulovic ◽  
Gordana Djordjevic ◽  
Savo Durkovic ◽  
Davor Stamenovic ◽  
...  
Keyword(s):  
Case Report ◽  
Oxygen Saturation ◽  
Traffic Accident ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Rapid Diagnosis ◽  
Blunt Injury ◽  
Bronchial Stenosis ◽  
Low Oxygen ◽  
The Right

Introduction Severe blunt injury of the chest can cause rupture of the tracheobronchial tree. After completed management of the injury, stenosis of the bronchi may develop at the site of the rupture. Such condition is associated with pathophysiolocical disorders, which then indicates to the possible presence of the bronchial stenosis. Case report We report a patient with stenosis of the right main bronchus due to blunt injury sustained in a traffic accident. We present all pathophysiological signs detected during examination. The patient had dyspnea, cianosis, tachycardia, low oxygen saturation and low pO2. We performed right thoracothomy and resection of the main bronchus with TT anastomosis. Conclusion It is very useful to understand the described pathophysiological signs so as to ensure rapid diagnosis of stenosis, but also better and timely solving of problems that can occur during thoracothomy.

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