Foreign bodies in the tracheobronchial tree: practical issues in relation to adult patients
M.L. SHTEINER1,2, Yu.I. BIKTAGIROV1, E.A. KORYMASOV1, E.P. KRIVOSHCHEKOV1, A.V. ZHESTKOV1, A.D. PROTASOV1
1Samara State Medical University, 89 Chapaevskaya Str., Samara, Russian Federation, 443099
2Samara City Hospital No. 4, 125 Michurin Str., Samara, Russian Federation, 443056
Shteiner M.L. — D. Med. Sc., physician-endoscopist; Assistant of the Department of Surgery with the course of endoscopy, tel. +7-917-108-03-99, e-mail: [email protected] yandex.ru
Biktagirov Y.I. — Cand. Med. Sc., Associate Professor of the Department of Surgery, Head of the course of Endoscopy, tel. +7-927-713-01-59; e-mail: [email protected]
Korymasov E.A. — D. Med. Sc., Professor, Head of the Surgery Department, tel. +7-927-608-00-41; e-mail: [email protected]
Krivoshchekov E.P. — D. Med. Sc, Professor of the Surgery Department, tel. +7-927-688-42-89; e-mail: [email protected]
Zhestkov A.V. — D. Med. Sc, Professor, Head of the Department of General and Clinical Microbiology, Immunology and Allergology, tel. +7-846-260-33-61; e-mail: [email protected]
Protasov A.D. — Cand. Med. Sc., Associate Professor of the Department of General and Clinical Microbiology, Immunology and Allergology, tel. +7-927-744-41-26; e-mail: [email protected]
In adult patient practice, the majority of foreign body aspirations usually happen in patients with acute encephalopathy of different genesis. Most often such patients are admitted to hospital with delay when they have already developed pneumonia. This study is aimed at estimating the problem of foreign bodies in the tracheobronchial tree during general examination by physician-bronchologist. We analyze all cases of diagnosis and removal of foreign bodies from the tracheobronchial tree in hospitalized patients over the period between 2006 and 2016. Of 10799 (100.00 %) primary bronchoscopies performed for therapeutic or diagnostic purposes, in 46 (0.43 %) cases the foreign bodies were found. In 44 cases (95.62 %) there was no reference to aspiration in the past. In 9 cases (19.56 %) analysis of medical history enabled to suspect the presence of foreign bodies in the tracheobronchial tree. 41 patients (89.13 %) with diagnosed foreign bodies had been hospitalized in the Pulmonology Department with diagnosis “Community-acquired pneumonia” and 5 patients (10.87 %) had received the inpatient treatment in the Neurology Department. In 15 cases (32.61 %) the endoscopy diagnostics was clear. In 31 cases (67.39 %) foreign bodies were considered to be the “old” ones. In 43 cases (93.48 %) foreign bodies were removed with flexible bronchoscopy procedure. In 38 cases (82.61 %) foreign bodies in the tracheobronchial tree were of organic origin. In adult patient practice the major problem with the diagnostics of foreign bodies in the tracheobronchial tree is the absence of reference to past aspiration. Visual estimation of the “old” foreign bodies in the tracheobronchial tree requires differential diagnosis with the oncology process. For effective removal of foreign bodies from the tracheobronchial tree the grasping forceps should be used, which allow the manipulation in a limited space of the tracheobronchial tree.
Key words: bronchoscopy, foreign bodies in the tracheobronchial tree.
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