Page 58 - ECBIP 2021_Program
P. 58

6th European Congress ECBIP 15 - 17
  Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
 MODERATED e-POSTER SESSION 04:
Central airways obstruction and foreign body extraction
        ALTERNATIVE METHOD FOR FOREIGN BODY REMOVAL BY FLEXIBLE BRONCHOSCOPY
Nuno Faria1, Catarina Dias1, Joana Gomes1, Francisca Tavares2, Conceição Rodrigues1, Cristina Viana1, Maria Sucena1
1 Department of Pulmonology, Centro Hospitalar Universitário Do Porto, Porto, Portugal
2 Department of Anaesthesiology, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
     PP25
    Introduction: Foreign body (FB) aspiration is an uncommon and potential life-threatening emergency, particularly if complete obstruction of the trachea occurs. Rigid bronchoscopy is the preferred method for removing FB. Also, lower airway FB aspiration is usually accompanied by sudden-onset cough, wheeze or dyspnea and most commonly gets lodged in the main or intermediate right bronchi. Partial obstructions that do not trigger severe respiratory distress can usually be removed by flexible bronchoscopy if coughing fails to expel the FB.The use of retrieval basket is established as a method with minimal complications for FB removal if it is possible to encompass the entire FB. In this context, the authors describe a case of non- acute FB approached by flexible bronchoscopy and successfully removed by a less conventional method.
Clinical case: A 70 years-old man with chronic obstructive pulmonary disease (COPD), obstructive sleep apnea (OSA) and incipient dementia was hospitalized for pneumonia. Patient did not report any episode of choking or acute respiratory symptoms. Chest computed tomography revealed left lower lobe (LLL) and left upper lobe (LUL) consolidations. Given poor response to piperacillin-tazobactam and there was suspicion of neoplasia, patient was proposed for bronchoscopy. Flexible bronchoscopy revealed a FB (almond) lodged in the terminal portion of the left main bronchus. Unsuccessful removal was attempted by aspiration and forceps. Since neither rigid bronchoscopy nor cryoprobe is performed in our hospital (patient transfer to another hospital would be required) and retrieval basket was unavailable, foreign body was approached through Fogarty catheter. After placing the catheter immediately below the foreign body, the balloon was inflated to its maximum and an en bloc rail movement was performed with continuous balloon inflation until the almond (17mm diameter) was extruded through the mouth. Post procedure review of the area revealed underlying granulation tissue.
Conclusion: We present a case of unperceived FB aspiration in the left main bronchus, successfully resolved by a less used method. Although commonly used in bronchology to promote haemostasis, Fogarty’s catheter can thus be an effective alternative for the removal of FB occluding main bronchi.
  Figure 1: Foreign body before removal, lodged in the distal third of the left main bronchus
Figure 2: Foreign body crossing the trachea during its removal.
        USING OF FLEXIBLE BRONCHOSCOPY IN FOREIGN BODY ASPIRATION
Gökçen Ünal1, Sevgi Pekcan1, Tahir Tok2, Aslı Imran Yılmaz1
1 Necmettin Erbakan Üniversity, Meram Faculty of Medicine, Pediatric Pulmonology, Konya, Turkey 2 SeydiSehir Devlet Hastanesi, Pediatrics, Konya, Turkey
      PP26
   Objective: Foreign body aspiration continues to be a serious health problem that can lead to severe consequences in children and cause acute and chronic problems. Requires immediate intervention. Rigid bronchoscopy has always been the preferred method for foreign body removal, but flexible brochoscopy has replaced rigid bronchoscopy because it causes less trauma and can reach distal bronchial areas.
In our study, we aimed to evaluate our patients whose foreign body was removed by flexible bronchoscopy in our clinic.
Materials and Methods: The records of 20 patients who underwent flexible bronchoscopy and removed foreign bodies in our clinic due to suspicion of foreign body aspiration were examined. Sociodemographic data were evaluated in terms of the foreign bodies removed and the method of removal, the region where it was removed, and the duration of diagnosis.
Results: Nine of our patients were female and 11 were male. The youngest of our patients was eight months old, the oldest patient was 44 months old, and the age of 13 patient was between 12-18 months. Organic items such as hazelnuts, peanuts, seeds, almonds and corn were removed from 12 patients, bone was removed from one and gelatin was removed from one of them. It was cleaned by aspirating an apple from one patient and egg from one patient. Organic material was removed in all four patients, but it could not be determined. Baskets, triceps and forceps were used for removal. Foreign bodies were extracted in the left main bronchus in six patients, in the left inferior lobe in two patients, in the right main bronchus in five patients, in the right middle lobe in three patients, in the right superior lobe in one patient, in the trachea in one patient, and in the epiglottis in one patient.
Conclusion: In children, foreign body can be removed with minimal complications using flexible bronchoscopy, baskets and forceps.
58 6th European Congress for Bronchology and Interventional Pulmonology
  







































































   56   57   58   59   60