A Study of Clinical Presentations and Complications of Foreign Body in the Bronchus-Our Experience

OBJECTIVES: In this study, we attempted to study the varied clinical presentations and complications of foreign body in the airway and the complications of bronchoscopy, if any. METHODS: A prospective observational clinical study in a tertiary care centre from June 2010 to May 2012 included 46 paediatric patients aged less than 12 years with suspected foreign body aspiration, all of whom underwent Rigid Bronchoscopy under General Anaesthesia. All the patients were subjected to History Taking, Clinical Examination& Investigations (Pre and Post-op X-Ray Chest and CT Virtual Bronchoscopy, if required). RESULTS: The most common age of presentation was 1 to 3 years mostly presenting within 48 hours of aspiration.87 % of the patients had a definite history of aspiration, with Cough (69.5 %) and Unilateral Decreased Air Entry (91.3 %) being the most common symptom and clinical sign respectively. Emphysema was the most common finding on X-ray Chest (71.7 %) and the sensitivity of CT Virtual Bronchoscopy was 80 %. Majority of the Foreign Bodies were Organic (84.7 %-esp. peanut) and mostly found in the Right Bronchus (47.8 %). Post-op complications were rare (Pneumothorax, Pneumonic patch) and were managed conservatively. None of the patients required a Tracheostomy and there was Zero Mortality. CONCLUSIONS: A positive history is by itself an indication for Bronchoscopy. Clinical Signs and X-Ray changes should guide the clinician towards the possible location of the foreign body. CT Virtual Bronchoscopy can be done in cases with no specific history or clinical signs. Bronchoscopy can be done with minimal complications when performed by co-ordination of expert surgeon and anaesthetist.