Endoscopic procedures for removal of foreign bodies of the aerodigestive tract: The Bugando Medical Centre experience.
BACKGROUND
Foreign bodies in the aerodigestive tract continue to be a common problem that contributes significantly to high morbidity and mortality worldwide. This study was conducted to describe our own experience with endoscopic procedures for removal of foreign bodies in the aerodigestive tract, in our local setting and compare with what is described in literature.


METHODS
This was a prospective descriptive study which was conducted at Bugando Medical Centre between January 2008 and December 2009. Data were collected using a structured questionnaire and analyzed using SPSS computer software version 15.


RESULTS
A total of 98 patients were studied. Males outnumbered females by a ratio of 1.1:1. Patients aged 2 years and below were the majority (75.9%). The commonest type of foreign bodies in airways was groundnuts (72.7%) and in esophagus was coins (72.7%). The trachea (52.2%) was the most common site of foreign body's lodgment in the airways, whereas cricopharyngeal sphincter (68.5%) was the commonest site in the esophagus. Rigid endoscopy with forceps removal under general anesthesia was the main treatment modality performed in 87.8% of patients. The foreign bodies were successfully removed without complications in 90.8% of cases. Complication rate was 7.1% and bronchopneumonia was the most common complication accounting for 42.8% of cases. The mean duration of hospital stay was 3.4 days and mortality rate was 4.1%.


CONCLUSIONS
Aerodigestive tract foreign bodies continue to be a significant cause of childhood morbidity and mortality in our setting. Rigid endoscopic procedures under general anesthesia are the main treatment modalities performed. Prevention is highly recommended whereby parents should be educated to keep a close eye on their children and keep objects which can be foreign bodies away from children's reach.
Department of Surgery, Weill- Bugando University College of Health Sciences, Mwanza, Tanzania.
Japhet M
JM
Gilyoma
Department of Surgery, Weill- Bugando University College of Health Sciences, Mwanza, Tanzania.
Phillipo L
PL
Chalya
Br J Surg. 1978 Jan;65(1):5-9
623968
J Pak Med Assoc. 1999 Feb;49(2):33-6
10513434
Laryngoscope. 1988 Jun;98(6 Pt 1):615-8
3374237
Med J Malaysia. 2010 Jun;65(2):143-5
23756800
Ann Otol Rhinol Laryngol. 1980 Sep-Oct;89(5 Pt 1):434-6
7436247
Int J Pediatr Otorhinolaryngol. 1998 May 15;43(3):217-27
9663943
East Afr Med J. 2002 Jun;79(6):334-8
12638825
Laryngoscope. 1991 Jun;101(6 Pt 1):657-60
2041447
Laryngoscope. 1997 Jan;107(1):17-20
9001259
J Pediatr Surg. 1984 Oct;19(5):531-5
6502421
Am J Dis Child. 1980 Jan;134(1):68-71
7350789
J Sci Res Med Sci. 2001 Oct;3(2):117-20
24019718
Otolaryngol Clin North Am. 2000 Feb;33(1):179-85
10637351
Otolaryngol Head Neck Surg. 2000 Nov;123(5):613-6
11077351
Auris Nasus Larynx. 2003 Dec;30(4):397-401
14656566
Chest. 1987 May;91(5):730-3
3568776
Ann Otol Rhinol Laryngol. 1981 Jul-Aug;90(4 Pt 1):316-22
7271141
Int J Pediatr Otorhinolaryngol. 2001 Apr 6;58(1):37-45
11249978
Clin Pediatr (Phila). 1997 Dec;36(12):701-6
9415838
Bol Asoc Med P R. 2000 Sep-Dec;92(9-12):124-9
14619147
J Pediatr Surg. 2003 Feb;38(2):227-9
12596109
Surg Endosc. 2000 Jul;14(7):644-8
10948301
Ann Otol Rhinol Laryngol. 1996 Apr;105(4):267-71
8604886
Pediatr Rev. 2000 Mar;21(3):86-90
10702322