Tracheobronchial foreign bodies inhalation in al-Anbar Government

الملخص EN

-Background: Aspirated tracheobronchial foreign bodies in infants , children & adults occur throughout the world .

Objective : To determine the type of foreign bodies , common site , procedure for removal of foreign bodies.

Materials& methods: This is a descriptive study was done Over a period of 2 years in Al_Anbar government in the period of From January 2008 to December 2009, 100 case were referred to the department of thoracic & cardiovascular surgery of Al-Ramadi teaching hospital & Al- Fallujah General hospital in Al-Anbar government because of suspected aspiration of tracheobronchial foreign bodies.

The data collected were included age ,gender , history of foreign bodies inhalation from the patients or from their relatives.

In 75 instances, a definite history of foreign body inhalation was obtained & confirmed at bronchoscopic examination, the remaining 25 patients, about whom such information was unobtainable, where treated for some time as if they had a chest infection, at bronchoscopic study, however, a foreign body was found in 15 cases.

Results: The youngest patient was 5 months old ,& the accident was most prevalent in children between the ages of 1-5 Years in 73 patients with or suspected foreign bodies inhalation in trachea or bronchus ,with nearly equal in female & male 51%,49% respectively.

Metallic foreign bodies in 29% of cases & seeds in 28% ,67% of foreign bodies arrested at right main bronchus & watermelon in 35.8% in right bronchus .

No radiological finding in 32 % ,& 64% without significant complication with rigid or flexible bronchoscopy, while laryngeal edema in 23% of complication treated conservative.

Rigid bronchoscopy in 87 cases while flexible in 15 cases recently admitted to Al- Fallujha General hospital .

Lastly 75 cases with history of foreign body inhalation & 25 cases with no clear history.

Conclusion & Recommendation: 1.

In Al-Anbar as other part of Iraq ,the prevalence of tracheobronchial aspiration of foreign bodies in children is high than adults.

2.

The complication rate increases as the time to the diagnosis and extraction of the object exceeds 24 hours.

3.

Bronchoscopy ( rigid & flexible ) can be both diagnostic & therapeutic .

4.

Thoracic surgeons are familiar with both techniques , the rigid & the flexible types in diagnosis & therapy ,while chest physicians are allowed to practice flexible bronchoscopy for diagnostic procedure .

5.

Bronchoscopy is a simple & safe procedure but when an accident occur ,serious complication may arise with devastating rapidity .

6.

Theoretically ,the prevention of foreign bodies is simple ; in practice ,it is almost impossible .

7.

Holding an infant's head downwards in the hope that it will come out should never be attempted ; for ,if the foreign body is free in trachea or one of the bronchi ,it is then apt to be displaced & become impacted in subglottic region resulting in asphyxia & sudden death .

8.

Heimlich maneuver, may be successfully treated in acute choking, with respiratory failure associated with tracheal or laryngeal foreign body obstruction.