気道異物症例の臨床的特徴 : 摘出に難渋した症例に関する考察 [in Japanese] Clinical Characteristics of Airway Foreign Bodies in Which Bronchoscopic Removal Was Difficult [in Japanese]
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Background. Airway foreign bodies may cause suffocation and pneumonia. Therefore, accurate diagnosis and expeditious removal are needed. However, we sometimes experience difficulty in removing foreign bodies from the airway by bronchoscopy. Methods. We examined the clinical characteristics of 15 cases of foreign body managed in our institute over the past 19 years, and evaluated characteristic difficulties during bronchoscopic removal. Results. The mean age of cases was 58 years. Four patients had dementia as their underlying disease. Episodes of aspiration occurred in 10 patients. Dental foreign bodies were seen in 9 patients (60%). Chest X-ray films detected foreign bodies in 11 patients (73%), and chest computed tomography identified them in all patients. Alligator forceps and basket forceps were mainly used for removal. Fogarty forceps were also used in combination with the above in 2 patients. The foreign body was removed during the first procedure in 12 patients; however, further procedures were needed (20%) in the remaining 3 patients: using different bronchoscopic techniques, tracheotomy and surgical resection, respectively. The characteristics of these 3 cases were as follows; granulation forming around a sharp foreign body obstructing the bronchus for a prolonged period, inability of the patient to lie still due to dementia, and tracheal stenosis after tracheotomy. Conclusion. Characteristic difficulties during bronchoscopic removal were granulation around the foreign body, inability of the patient to lie still, and tracheal stenosis. When difficulties in bronchoscopic removal are expected, it is necessary to prepare a variety of devices in advance.
- The Journal of the Japan Society for Respiratory Endoscopy
The Journal of the Japan Society for Respiratory Endoscopy 34(1), 6-10, 2012
The Japan Society for Respiratory Endoscopy