title: Intrinsic endobronchial obstructions in children from Turkey: evaluation of 2,555 flexible bronchoscopic procedures.
abstract: BACKGROUND
  Endobronchial obstructions are rarely seen in children and are often misdiagnosed resulting in delay of definitive treatment. A variety of diseases can cause endobronchial obstructions in childhood, but data is limited as to the frequency, distribution and clinical characteristics of endobronchial obstructions diagnosed with flexible bronchoscopy (FB).
  
  
  OBJECTIVE
  To document endobronchial obstructions detected by FB.
  
  
  METHODS
  FB results from three pediatric pulmonology centers in Istanbul were evaluated.
  
  
  RESULTS
  A total of 2,555 children underwent an FB procedure during the study period. Endobronchial obstructions were detected in 10% (n = 256) of the patients. Among FB in patients who had endobronchial obstructions, the four most common indications for bronchoscopy were persistent infiltrations (30%, n = 72), persistent wheezing (28%, n = 70), chronic cough (26%, n = 66) and atelectasis (23%, n = 59). The most common endobronchial obstructions detected in the patients were aspirated foreign bodies (35.9%, n = 92), endobronchial tuberculosis (31.6%, n = 81), mucous plugs occluding airway (16.7%, n = 43) and granulation scars (6%, n = 16). Other pathologies included hydatid cysts (n = 5), hemangiomas (n = 5), tumors (n = 5), submucosal nodules (n = 5) and polyps (n = 4). Endobronchial obstructions were most commonly located in the right bronchus (51%, n = 130) followed by the left bronchus (33%, n = 85), bilaterally (8%, n = 21) and trachea (8%, n = 20).
  
  
  CONCLUSIONS
  Endobronchial obstructions can be caused by a number of different diseases which require various medical or surgical treatments. In the presence of clinical or radiological findings suggesting an endobronchial obstruction, FB should be performed promptly.
authors.affiliation: Department of Pediatric Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey.
authors.forename: Arif
authors.initials: A
authors.lastname: Kut
authors.forename: Erkan
authors.initials: E
authors.lastname: Cakir
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Gokdemir
authors.forename: Levent
authors.initials: L
authors.lastname: Midyat
authors.forename: Refika
authors.initials: R
authors.lastname: Ersu
authors.forename: Ela
authors.initials: E
authors.lastname: Erdem
authors.forename: Bulent
authors.initials: B
authors.lastname: Karadag
authors.forename: Fazilet
authors.initials: F
authors.lastname: Karakoc
mesh_terms: D001980:Bronchi / Q000473:pathology*; D001982:Bronchial Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D020680:Bronchoscopes; D001999:Bronchoscopy / Q000379:methods*; D002675:Child, Preschool; D003251:Constriction, Pathologic; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D014421:Turkey / Q000453:epidemiology