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Pseudobronchial crista-like change is an unusual type of inflammatory granulation tissue hyperplasia in the endobronchial membrane caused by chronic retention of bronchial foreign bodies. Here, we report a case of pseudobronchial crista-like change in a 4-year-old boy who required admission for intermittent cough for >10 days and wheezing for 2 days. The main manifestation was persistent and non-healing lobar pneumonia. Initial electronic bronchoscopy showed cristae at the distal left main bronchus, which was misdiagnosed as bronchial opening stenosis. Repeat electronic bronchoscopy was performed after standard antibiotic treatment proved ineffective. Foreign bodies were observed at the opening of the basal branch of the left lower lobe. The left main bronchial cristae were clamped. The cristae appeared to be a pseudobronchial crista-like change caused by long-term retention of bronchial foreign bodies. After CT-confirmation of no abnormal blood supply at the cristae, the bronchial foreign bodies were removed, and the distal cristae of the left main bronchus were cut-off by laser, followed by balloon dilatation. To our knowledge, no similar cases have been reported so far in our review of domestic and foreign literature. Insufficient clinical understanding of Pseudobronchial Crista-like Change increase the risk of misdiagnosis and missed diagnosis. Detailed exploration and careful identification under bronchoscopy are helpful for the timely diagnosis and treatment of Pseudobronchial Crista-like Change.

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.

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.

Bronchial foreign body is a common health problem worldwide, types of bronchial foreign bodies are variegated, depending on patient age and cultural background including religious beliefs as well as alimentary habits. However, misdiagnoses caused by regional dietary correlation factors were rarely concerned. In this case, a 52-year-old woman with aggravated cough and hemosputum took thoracic CT scan twice and flexible fiberoptic bronchoscopy 5 times, which all revealed the chronic pulmonary inflammation. Furthermore, the biopsies showed bronchial granulation nodule formation. With the highly suspicion of tumor, lung lobe resection was conducted. However, from the resected specimen, we belatedly found a red pepper inserted in the bronchus, without tumor cell in postoperative pathological analysis. We reviewed the case, analyzed the potential factors that may led to repeated misdiagnoses, and concluded that regional dietary characteristics and higher clinical suspicion should be seriously under consideration in the process of diagnosis.

OBJECTIVE: The aim of this study was to analyze the risk factors for granuloma formation caused by plant-based tracheobronchial foreign bodies in children, and investigate the underlying pathogenesis.
METHODS: In this retrospective analysis of 153 cases with tracheobronchial foreign bodies (peanuts and watermelon seeds), 35 cases of granuloma formation as granulation group (G), and 118 cases of no granuloma formation as non-granulation group (NG) were studied. Clinical data pertaining to sex (S), age (A), foreign body surface smoothness (SF), foreign body shape (SH), foreign body oil release state (O), the location of foreign bodies (L), and foreign body retention time (T) were collected for statistical analysis.
RESULTS: Univariate analysis showed no significant difference between the two groups (G and NG) with respect to S, A, SH and L. Significant factors based on univariate analysis included SF, O and T. Multivariate logistic regression analysis revealed that SF and T were independent risk factors associated with development of granuloma.
CONCLUSIONS: SF, O and T had relationship with the granuloma formation. Local trauma caused by an irregular and sharp foreign body, and extended period of time represent the main factors causing granuloma formation.

OBJECTIVE: To explore the seasonal correlation of the incidence of bronchial foreign body.
METHODS: Conduct retrospective analysis on clinical data of 1819 cases with bronchial foreign bodies in our hospital within an eight-year period (from January 2005 to January 2012), with cases classified into 12 groups by admission time (calculated by the Gregorian calendar in months, from January to December) and 4 groups by the Gregorian calendar in seasons (spring from March to May, summer from June to August, autumn from September to November, and winter from December to February), and observe whether the number of inpatients indicates any monthly or seasonal correlation.
RESULTS: The months of November and December indicated the highest number of inpatients, with 263 cases and 274 cases, which accounted for 12.7% and 13.2% of all reported cases, respectively. On the other hand, June and July had the lowest number of inpatients, with 96 cases and 75 cases, which accounted for 4.6% and 3.6%, respectively. Based on season, 749 cases were admitted in autumn, accounting for 35.1%; 636 cases were admitted in winter, accounting for 29.8%; 474 cases were admitted in spring, accounting for 22.2%; and 275 cases were admitted in summer, accounting for 12.9%. The number of inpatients was periodic, with 12 months as a cycle, and significant difference (P<0.01) was determined by comparing the numbers of inpatients in winter and spring and those in summer and spring.
CONCLUSIONS: The number of child in patients with bronchial foreign bodies is monthly periodic, with 12 months as a cycle, and respectively reaching the peak in November and December, and the valley in June and July; the seasonal characteristic was apparently related to the monthly characteristic, with the numbers of inpatients in autumn and winter each year being significantly higher than in the spring and summer, and the incidence showing apparent seasonal correlation. The results allow for the proposal of relevant precautionary measures against bronchial foreign bodies in children.

OBJECTIVE: Late-diagnosed bronchial foreign bodies can lead to irreversible changes in the bronchi and the lungs. To date, few reports are available concerning surgical treatment for this condition. The present report summarizes clinicopathological features and surgical treatment options for late-diagnosed bronchial foreign body aspiration.
METHODS: Clinical data of 23 patients who underwent surgical treatment for late-diagnosed bronchial foreign body aspiration in our hospital from 1980 to 2010 were reviewed.
RESULTS: The patients included 17 male and six female patients, aged 6 to 66 years. To remove the foreign body, bronchotomy was performed in six patients and pulmonary resection in 17 patients. Foreign bodies were located on the right side in 17 cases and on the left side in six cases. The majority of the foreign bodies were of food origin. Postoperative bronchopleural fistula occurred in two patients. One patient died of renal failure subsequent to lung infections.
CONCLUSIONS: Detailed history, awareness of potential foreign body aspiration and thorough bronchoscopic examination are helpful to avoid pulmonary resection. However, the latter is necessary in patients with the associated substantial lung lesions to prevent these from progressing into serious lung infections such as pulmonary suppuration or empyema.