title: Inhaled foreign bodies: presentation, management and value of history and plain chest radiography in delayed presentation.
abstract: OBJECTIVE
  To assess the clinical and management aspects of tracheobronchial foreign body (FB) in children and adults; to judge the influence of the operator's experience on the outcome of the procedure and to evaluate the factors associated with delayed diagnosis of FB aspiration (FBA) in children; and to compare clinical, radiologic and bronchoscopic findings in the patients with suspected FB inhalation (FBI).
  
  
  METHODS
  Retrospective review of a 10-year experience (from 1995 to 2005), involving a 1512-bed Mansoura university hospital and a 184-bed Mansoura emergency hospital.
  
  
  METHODS
  Three thousand three hundred patients underwent rigid bronchoscopy for suspected FBI between 1995 and 2005 in Mansoura, Egypt. The data were analyzed in 3 groups: the patients with negative bronchoscopy for FBI (group 1), early (group 2), and delayed diagnosis (group 3). Foreign body was removed using the rigid bronchoscope with or without using the extracting forceps (Egyptian novel technique; Sersar technique).
  
  
  RESULTS
  The penetration syndrome and decreased breath sounds were determined in a significantly higher number of the patients with FBI. The plain chest radiography revealed radiopaque foreign bodies (FBs) in 23.56% of all patients with FBI. Pneumonia and atelectasis were more common in the groups with negative bronchoscopy and with delayed diagnosis (P < 0.01). The FBs were mostly of vegetable origin, such as seeds and peanuts. The Egyptian novel (Sersar) technique was used since 2004 April in 100 cases (4.62%) with a history of FBI (pins and or small rounded materials). It was successful in 73 cases of nonimpacted inhaled pins.
  
  
  CONCLUSIONS
  Bronchoscopy is indicated on appropriate history and on suspicion. To prevent delayed diagnosis, characteristic symptoms, and clinical and radiologic signs of FBI should be checked in all suspected cases. Because clinical and radiologic findings of FBI in delayed cases may mimic other disorders, the clinician must be aware of the likelihood of FBI.
  
  
  METHODS
  C-4.
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, 35516 Mansoura, Egypt. sameh001@yahoo.com
authors.forename: Sameh Ibrahim
authors.initials: SI
authors.lastname: Sersar
authors.forename: Walid Hassan
authors.initials: WH
authors.lastname: Rizk
authors.forename: Maha
authors.initials: M
authors.lastname: Bilal
authors.forename: Mohammed M
authors.initials: MM
authors.lastname: El Diasty
authors.forename: Tarik Abudlla
authors.initials: TA
authors.lastname: Eltantawy
authors.forename: Bahaa Badry
authors.initials: BB
authors.lastname: Abdelhakam
authors.forename: Adel Mohamed F
authors.initials: AM
authors.lastname: Elgamal
authors.forename: Alaa Ali Abou
authors.initials: AA
authors.lastname: Bieh
mesh_terms: D000293:Adolescent; D000328:Adult; D001980:Bronchi; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005547:Foreign Bodies / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007223:Infant; D008487:Medical History Taking; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D014132:Trachea