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Sudan Journal of Medical Sciences

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Prevalence, Management and Complications of Foreign Body Bronchus in Sudanese Children

SAO Ahmed

Abstract


Background: Inhalation of foreign bodies (FBs) is a common problem in Sudanese children. Its incidence has not changed significantly but the safety of removal has improved dramatically. Most of the airway FBs was in patients younger than 15 years of age.
Methodology: This is a retrospective study conducted in Ibn Sina and Al Doha ENT hospitals from Jan 2008 to Dec 2010 using rigid bronchoscopy in Sudanese children who had foreign bodies (FBs) in the bronchus.
Result: A total of 150 bronchoscopies was performed : 89 cases (56%) were below 2 years of age;45 cases(30%) were between 2-5 years ;and 18 cases (14%) were over 5 years of age . In 88 cases (58.7%) the foreign bodies inhalations (F.Bs) were peanuts and in 27 cases (18%) were
watermelon seeds, and most of the FBs were found in children under 5 years of age. Pins and needles were found in 8cases (5.3%) mostly teenage females. Most of the FBs (82.7%) were radiolucent showing minimal or no X-ray findings. Most of the bronchoscopy (80%) was done as
an elective. All FBs could be found by bronchoscopy and 90% of FBs were located in the right main bronchus. Ninety percent of the FBs were successfully removed. In 5% of patients they were removed partially. In only 5% of the patients, the procedure failed. The majority of FBs which
were not removed were pins and needles. Urgent tracheostomy was done for three cases (2%) to remove a large FB through the stoma. Several complications were reported either due to the inhaled FBs or due to bronchoscopic procedure. In one patient (0.7%) perforation of bronchus occurred and chest tube with under water seal was inserted. Only one cases (0.7%) had operative mortality. In two cases (1.3%) the mortality was due to inhaled FBs. Overall mortality was 2%.
Conclusion: Certain food items especially peanuts if given to children have to be given with caution and under close supervision. In a child who develops sudden wheezes where asthma has not been previously diagnosed and no persistent chest infection was suspected, bronchoscopy should always be considered. Bronchoscopy should be performed as an elective procedure for its favorable outcome. Intraoperative tracheostomy sometimes is mandatory to remove hard and sizable FBs



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