bronchial foreign body

支气管异物
  • 文章类型: Case Reports
    异物吸入是常见的情况,所有年龄组均出现严重结局。它可以像任何慢性呼吸道疾病一样表现出广泛的误导性症状,导致误诊和延误适当的治疗。
    方法:这里我们介绍一个11岁男孩诊断为隐匿性异物吸入的病例,慢性影响左次支气管,出现支气管扩张和多次尝试支气管镜检索失败。
    通过小型开胸手术进行左下叶肺叶切除术,用带蒂背阔肌皮瓣加固。前期手术将减少因水肿和反复全身麻醉风险而需要盆式通气支持的反复尝试中引起的支气管镜发病率。
    结论:高度怀疑是诊断的关键。慢性嵌塞的手术管理应具有较低的阈值。
    UNASSIGNED: Foreign body aspiration is a common occurrence, with severe outcomes seen in all age groups. It can present like any chronic respiratory disease with a wide spectrum of misleading symptoms, resulting in misdiagnosis and delays in appropriate treatment.
    METHODS: Here we present a case of a 11 year boy diagnosed with occult foreign body aspiration, chronically impacted in the left secondary bronchus, presented with bronchiectasis and multiple failed attempts at bronchoscopic retrieval.
    UNASSIGNED: Surgically managed by a left lower lobe lobectomy via a mini thoracotomy, reinforced with a pedicled latissimus dorsi flap. Upfront surgery will reduce the bronchoscopic morbidity incurred in repeated attempts needing pot-op ventilatory support due to edema and repeated general anaesthesia risks.
    CONCLUSIONS: A high degree of suspicion is a key to diagnosis. There should be a low threshold for surgical management in chronic impactions.
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  • 文章类型: Case Reports
    支气管异物吸入是一种危及生命的紧急情况。很大程度上,发表的文献集中在通过支气管镜切除异物,而手术切除支气管内异物的报道很少。因此,我们介绍了一例支气管异物,通过电视胸腔镜手术(VATS)支气管切开术成功切除,在多次尝试支气管镜失败后。
    方法:一名77岁男性患者在接受牙科治疗后表现为持续咳嗽和低热2个月。支气管镜检查显示,右基底支气管中的牙冠被肉芽组织包围。患者在经历多次不成功的拔除后被转介到我们部门进行开放手术。通过VATS支气管切开术去除支气管异物。术后进展顺利,患者术后2天出院,无任何并发症。
    大多数吸入的气管支气管异物可以通过支气管镜取出;尽管如此,某些吸入的异物可能需要手术干预。此外,支气管切开术的适应症包括尽管反复尝试但未能清除异物,由于不动,有或没有远端支气管放置。胸腔镜检查有利于提供卓越的可视化,支气管切开术后恢复的可能性增加。
    结论:VATS支气管切开术是在不牺牲肺实质功能的情况下切除支气管异物的安全有效的替代方法。
    UNASSIGNED: Bronchial foreign body aspiration is a life-threatening emergency. Largely, the published literature focuses on the removal of foreign bodies by bronchoscopy, while the surgical removal of endobronchial foreign bodies is rarely reported on. Thus, we presented a case of a bronchial foreign body that was successfully removed by a video-assisted thoracoscopic surgical (VATS) bronchotomy, after multiple failed bronchoscopic attempts.
    METHODS: A 77-year-old male patient presented with a 2-month duration of a persistent cough and low-grade fever after undergoing dental treatment. Bronchoscopy revealed a dental crown surrounded by granulation tissue in the right basal bronchus. The patient was referred to our department for open surgery after undergoing multiple unsuccessful extractions. The bronchial foreign body was removed by a VATS bronchotomy. The postoperative course was uneventful, and the patient was discharged 2 days postoperatively without any complications.
    UNASSIGNED: Most aspirated tracheobronchial foreign bodies can be removed through bronchoscopy; nonetheless, certain aspirated foreign bodies may require surgical intervention. Furthermore, the indications for bronchotomies encompass the failure to remove the foreign body despite repeated attempts, due to immobility, with or without distal bronchial placement. Thoracoscopy is beneficial in providing superior visualization, with an increased likelihood of post-bronchotomy recovery.
    CONCLUSIONS: VATS bronchotomy is a safe and effective alternative for the removal of bronchial foreign bodies without sacrificing the functioning of the lung parenchyma.
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  • 文章类型: Case Reports
    由于氧化镁丸吸入的病例很少见,相关的气道促炎特性和适当的分析策略仍不清楚.一名出现呼吸困难的81岁女性被诊断为氧化镁丸吸入。计算机断层扫描,用左旋多巴进行“混合试验”,镁含量分析显示异物和她开的氧化镁丸的密度相似。患者在取出异物后恢复无气道并发症。临床医生应该意识到氧化镁片剂是老年患者潜在的支气管异物,因为它们在不暴露于胃液的情况下可能不会溶解。
    As cases of magnesium oxide pill aspiration are rare, the associated airway proinflammatory properties and appropriate analytic strategies remain unclear. An 81-year-old woman presenting with dyspnea was diagnosed with magnesium oxide pill aspiration. Computed tomography, a \"mixing test\" with levodopa, and a magnesium content analysis revealed a similar density between the foreign body and her prescribed magnesium oxide pill. The patient recovered without airway complications after foreign body removal. Clinicians should be aware of magnesium oxide tablets as potential bronchial foreign bodies in elderly patients because they may not dissolve without exposure to gastric juices.
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  • 文章类型: Journal Article
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  • 文章类型: English Abstract
    Spruce branch is a rare radiolucent bronchial foreign body. Despite modern imaging tests and endoscopic examination, this foreign body is often detected only intraoperatively. This study enrolled 4 patients with spruce branch aspiration. In the 4th case, spruce branch was removed during rigid bronchoscopy that was associated with «lodging» type of foreign body. In two cases, spruce branch migrated to peripheral bronchial segments («extrusive» type) that required surgical treatment (thoracoscopy with resection of the right basal pyramid segments and wedge resection of the right lower lobe). The 3rd case was the most interesting. Initially, the foreign body was «underlying», but it migrated after partial endoscopic removal that finally required right-sided lower lobectomy. This report describes the peculiarities of clinical course and management of patients with a rare type of radiolucent bronchial foreign body - spruce branch.
    Ветка елового дерева — редкий тип рентген-неконтрастного инородного тела бронхов. Несмотря на современные возможности лучевых и эндоскопических методов обследования, зачастую этот тип инородных тел обнаруживают только интраоперационно. Мы проанализировали 4 клинических случая лечения больных с аспирацией веткой хвойного дерева. В клиническом случае 4 инородное тело было полностью удалено при ригидной бронхоскопии, что определялось его нахождением в просвете бронха («залегающий» тип инородного тела). В 2 случаях еловая ветка мигрировала в периферические отделы трахеобронхиального дерева («экструзионный» тип), что потребовало хирургического лечения: в клиническом случае 1 выполнены видеоторакоскопия, резекция базальной пирамиды справа, в случае 2 — клиновидная резекция нижней доли правого легкого. Наиболее интересным нам представляется случай 3: изначально инородное тело было «залегающим», но после частичного удаления при фибробронхоскопии мигрировало, что в итоге потребовало выполнения видеоторакоскопии, нижней лобэктомии справа.
    UNASSIGNED: В представленной серии клинических случаев мы хотели продемонстрировать особенности течения данной патологии и свой опыт ведения больных с аспирацией веткой хвойного дерева.
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  • 文章类型: Case Reports
    Polycarbophil calcium (Polyful®; Mylan, Tokyo, Japan) is a stool stabilizer that absorbs liquid and swells to form a soft, bulky mass. A 75-year-old woman experienced sore throat and difficulty breathing immediately after taking the drug. Chest computed tomography showed a foreign body in the right intermediate bronchus. Bronchoscopy showed a white mass blocking the right intermediate bronchus. Since the mass was very fragile, we performed suctioning while breaking up the mass with a suction tube. The mass consisted of polycarbophil calcium. Since aspirated polycarbophil calcium swells and can obstruct bronchi, complete removal is crucial.
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  • 文章类型: Case Reports
    支气管异物患者常出现主观症状,主要是咳嗽,去除异物是困难的。支气管异物多位于右下支气管,很少在右支气管中部。一名85岁的男子没有主观症状。在去我们诊所的前一天,他在牙科治疗期间吸了一颗人造牙,并咨询了他的家庭医生。他因胸部X光片显示右中下肺野有异物而入院。胸部CT显示支气管异物位于右中支气管,它伴随着病变周围的伪影,它似乎是人造牙齿的金属片。三维CT显示人工牙根位于右中部支气管中心侧,and,考虑到侵入性,我们决定用柔性支气管镜切除牙齿。支气管镜检查发现一块金属片阻塞了右中支气管,没有肉芽,我们可以通过用鳄鱼钳抓住牙齿的根部立即移除牙齿。我们经历了位于右支气管中部的异物病例,没有呼吸道症状。重要的是要进行图像检查,因为老年患者可能不会出现呼吸道症状。
    Patients with bronchial foreign bodies often present with subjective symptoms, mainly cough, and removing the foreign bodies is difficult. Bronchial foreign bodies are mostly located in the right lower bronchus, and rarely in the right middle bronchus. An 85-year-old man had no subjective symptoms. He aspirated an artificial tooth during dental treatment the day before visiting our clinic, and consulted his home doctor. He was admitted to our hospital because a chest radiograph indicated the presence of a foreign body in the right middle and lower lung field. Chest computed tomography showed that the bronchial foreign body was located in the right middle bronchus, and it was accompanied by an artifact in the circumference of the lesion, and it seemed to be the metal piece of an artificial tooth. Three-dimensional CT showed the root of the artificial tooth located in center side of the right middle bronchus, and, considering the invasiveness, we decided to remove the tooth by flexible bronchoscopy. The bronchoscopy revealed a metal piece occluding the right middle bronchus without granulation, and we could remove the tooth immediately by grasping the root of the tooth with alligator forceps. We experienced a case of a foreign body located in the right middle bronchus without respiratory symptoms. It is important to carry out image examinations, because elderly patients may not exhibit respiratory symptoms.
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  • 文章类型: Journal Article
    UNASSIGNED: Multislice spiral computed tomography (MSCT) playsa vital role in the diagnosis of bronchial foreign bodies in children. Bronchitis (pneumonia) can be caused by bronchial foreign bodies in children, which need to be diagnosed and treated by bronchoscopy. To understand the application of MSCT in children with bronchitis (pneumonia) suspected to be caused by bronchial foreign bodies, the clinical data of 162 children were analyzed retrospectively.
    UNASSIGNED: The clinical data of 162 children with bronchitis (pneumonia) suspected to be caused by bronchial foreign bodies were collected, including sex, age, course of the disease, auscultation, chest X-ray, MSCT, bronchoscopy, among many others. Univariate logistic regression analysis analyzed the above other items, taking the finding of foreign bodies in bronchoscopy as the outcome index. The key variables of univariate analysis are included in multivariate logistic regression analysis to determine the independent influencing factors of bronchoscopy results.
    UNASSIGNED: Among the 162 patients, 70.4% were male, with the largest proportion of children aged 1-2 years (55.6%). The course of the disease of 98 cases (60.4%) was over14 days. A total of 111 cases (68.5%) showed positive auscultation, 110 cases (67.9%) showed positive chest fluoroscopy, 155 cases (95.7%) showed bronchial foreign bodies with MSCT, and the foreign bodies of 140 cases (86.4%) were removed by bronchoscopy. Univariate analysis showed that the course of the disease, chest auscultation, and MSCT were all correlated with the results of bronchoscopy. However, multivariate analysis showed, after adjusting the two factors of chest auscultation and chest fluoroscopy, the course of the disease (OR =6.01, 2.36-15.29, P<0.001) and MSCT (OR =95.64, 5.62-1,628.40, P<0.002) could still independently predict the results of bronchoscopy.
    UNASSIGNED: MSCT can independently predict the results of bronchoscopy in children with bronchitis(pneumonia) suspected to be caused by bronchial foreign bodies.
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  • 文章类型: Journal Article
    BACKGROUND: Delayed diagnosis of children with Bronchial Foreign Body (BFB) leads to significant pulmonary complications and open surgery may not be avoided. However, surgical management for children with BFB is rarely reported. This study aims to describe our experience in the diagnosis and surgical treatment of late-diagnosed BFB during childhood.
    METHODS: Medical records of 8 children who were diagnosed with BFB and underwent open surgery at Children\'s Hospital of Chongqing Medical University between January 2004 and June 2019 were retrospectively reviewed.
    RESULTS: This group consisted of 8 children, with an average age of 8.1 years. In this group, the typical aspiration history was absent and the diagnosis of BFB was established in delay. The onset of diseases varied from 2 months to over 4 years. Lobectomy was performed in 7 patients and pneumonotomy was performed in 1 patient. No postoperative death was found. The clinical outcomes were satisfactory with an average 33 months follow-up.
    CONCLUSIONS: The diagnosis of BFB should be considered in children who present with repeated pneumonia and agnogenic bronchiectasis and actelectasis despite repeated medical treatment. Surgical treatment is necessary and effective in patients with either unextractable BFB or irreversible damage of lung tissue.
    METHODS: Level IV.
    METHODS: Retrospective study.
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