[Foreign body aspiration in children. The advantages of emergency endoscopy and foreign body removal].
In the last 15 years, 124 children with a history and clinical signs of aspiration have been managed by emergency rigid endoscopy under general anesthesia. In 115 (93%) of them a foreign body could be identified, which was successfully removed by forceps extraction in 114. Only 1 patient required a thoracotomy for removal of a distally located aspirated needle. The remaining 9 patients (7%) had a typical history and clinical signs of an aspiration, but no aspirated foreign body was found on endoscopy. Most of the children (102, or 82%) were admitted within 12 h after aspiration, while 22 (18%) had a history of foreign body aspiration between 2 days and 5 weeks before. Complications occurred in only 3% (3 children) of the 102 who underwent endoscopy within 12 h as against 50% (11 patients) of the 22 children in whom this was delayed. In all cases of foreign body aspiration and endoscopical removal within 12 h, the patients were discharged after a plain chest X-ray the following day. In children with chronic endotracheal foreign bodies, in 80% a second endoscopy after 48 h was indicated, and the mean stay in hospital was extended to 7 days. Emergency rigid tracheobronchoscopy and forceps removal of aspirated foreign bodies under general anesthesia and with meticulous perioperative monitoring is a safe and effective procedure with no mortality. Even in suspected aspiration or chronic bronchopulmonary infections, liberal use of endoscopy is recommended.
Schimpl
G
G
Universitätsklinik für Kinderchirurgie, Graz.
Weber
G
G
Haberlik
A
A
Höllwarth
M E
ME
D000768:Anesthesia, General; D001980:Bronchi; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005547:Foreign Bodies / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007223:Infant; D001239:Inhalation; D008297:Male; D012189:Retrospective Studies; D014132:Trachea
Fremdkörperaspiration im Kindesalter. Vorteile der notfallmässigen Endoskopie und Fremdkörperentfernung.