Abstract
Abstract:Tracheobronchial foreign body (TFB) aspiration is rare in adults, although incidence rates increase with advancing age. Risk factors for TFB aspiration in adults are a depressed mental status or impairment in the swallowing reflex. Symptoms associated with TFB aspiration may range from acute asphyxiation with or without complete airway obstruction, to cough, dyspnea, choking, or fever. In adults, many other medical conditions mimic breathing abnormalities similar to those associated with TFB aspiration. If the history is not suggestive, then only a high index of suspicion can ensure proper diagnosis and timely removal of the foreign body. Initial treatment is airway support. Radiographic imaging may assist in localizing the foreign body. Bronchoscopic removal of the foreign body is necessary to avoid long-term sequelae. Flexible bronchoscopy is effective both in the diagnosis and removal of foreign bodies.
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References
References1. Limper AH, Prakash UB. Tracheobronchial foreign bodies in adults. Ann Intern Med 1990;112:604–609.LimperAH]]PrakashUBTracheobronchial foreign bodies in adults.Ann Intern Med1990112604-6092. National Safety Council. Leading Causes of Death: An Excerpt of Injury Facts. Chicago, IL, National Safety Council Press, 2003, pp 10–15.National Safety CouncilLeading Causes of Death: An Excerpt of Injury Facts.Chicago, ILNational Safety Council Press200310-153. Nakagawa T, Sekizawa K, Nakajoh K, et al. Silent cerebral infarction: a potential risk for pneumonia in the elderly. J Intern Med 2000;247:255–259.NakagawaT]]SekizawaK]]NakajohK&etal;Silent cerebral infarction: a potential risk for pneumonia in the elderly.J Intern Med2000247255-2594. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest 2003;124:328–336.MarikPE]]KaplanDAspiration pneumonia and dysphagia in the elderly.Chest2003124328-3365. Shaw DW, Cook IJ, Gabb M, et al. Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing. Am J Physiol 1995;268(3 part 1):G389–G396.ShawDW]]CookIJ]]GabbM&etal;Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing.Am J Physiol19952683 part 1G389-G3966. Vergis EN, Brennen C, Wagener M, et al. Pneumonia in long-term care: a prospective case-control study of risk factors and impact on survival. Arch Intern Med 2001;161:2378–2381.VergisEN]]BrennenC]]WagenerM&etal;Pneumonia in long-term care: a prospective case-control study of risk factors and impact on survival.Arch Intern Med20011612378-23817. Shaker R, Li Q, Ren J, et al. Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease. Am J Physiol 1992;263(5 part 1):G750–G755.ShakerR]]LiQ]]RenJ&etal;Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease.Am J Physiol19922635 part 1G750-G7558. Baharloo F, Veyckemans F, Francis C, et al. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest 1999;115:1357–1362.BaharlooF]]VeyckemansF]]FrancisC&etal;Tracheobronchial foreign bodies: presentation and management in children and adults.Chest19991151357-13629. al-Majed SA, Ashour M, al-Mobeireek AF, et al. Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. Respir Med 1997;91:293–296.al-MajedSA]]AshourM]]al-MobeireekAF&etal;Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery.Respir Med199791293-29610. Chen CH, Lai CL, Tsai TT, et al. Foreign body aspiration into the lower airway in Chinese adults. Chest 1997;112:129–133.ChenCH]]LaiCL]]TsaiTT&etal;Foreign body aspiration into the lower airway in Chinese adults.Chest1997112129-13311. Williams GS, Modi C, Singh T, et al. A case of black magic. South Med J 2008;101:552–553.WilliamsGS]]ModiC]]SinghT&etal;A case of black magic.South Med J2008101552-55312. Pinto A, Scaglione M, Pinto F, et al. Tracheobronchial aspiration of foreign bodies: current indications for emergency plain chest radiography. Radiol Med 2006;111:497–506.PintoA]]ScaglioneM]]PintoF&etal;Tracheobronchial aspiration of foreign bodies: current indications for emergency plain chest radiography.Radiol Med2006111497-50613. Zissin R, Shapiro-Feinberg M, Rozenman J, et al. CT findings of the chest in adults with aspirated foreign bodies. Eur Radiol 2001;11:606–611.ZissinR]]Shapiro-FeinbergM]]RozenmanJ&etal;CT findings of the chest in adults with aspirated foreign bodies.Eur Radiol200111606-61114. Ell SR, Sprigg A. The radio-opacity of fishbones—species variation. Clin Radiol 1991;44:104–107.EllSR]]SpriggAThe radio-opacity of fishbones—species variation.Clin Radiol199144104-10715. Kavanagh PV, Mason AC, Müller NL. Thoracic foreign bodies in adults. Clin Radiol 1999;54:353–360.KavanaghPV]]MasonAC]]MüllerNLThoracic foreign bodies in adults.Clin Radiol199954353-36016. Swanson KL, Prakash UBS, McDougall JC, et al. Airway foreign bodies in adults. J Bronchol 2003;10:107–111.SwansonKL]]PrakashUBS]]McDougallJC&etal;Airway foreign bodies in adults.J Bronchol200310107-11117. Debeljak A, Sorli J, Music E, et al. Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974–1998. Eur Respir J 1999;14:792–795.DebeljakA]]SorliJ]]MusicE&etal;Bronchoscopic removal of foreign bodies in adults: experience with 62 patients from 1974–1998.Eur Respir J199914792-79518. Surka A, Chin R, Conforti J. Bronchoscopic myths and legends: airway foreign bodies. Clin Pulm Med 2006;3:209–211.SurkaA]]ChinR]]ConfortiJBronchoscopic myths and legends: airway foreign bodies.Clin Pulm Med20063209-21119. Saw HS, Ganendran A, Somasundaram K. Fogarty catheter extraction of foreign bodies from tracheobronchial trees of small children. J Thorac Cardiovasc Surg 1979;77:240–242.SawHS]]GanendranA]]SomasundaramKFogarty catheter extraction of foreign bodies from tracheobronchial trees of small children.J Thorac Cardiovasc Surg197977240-24220. Ullyot DG, Norman JC. The Fogarty catheter: an aid to bronchoscopic removal of foreign bodies. Ann Thorac Surg 1968;6:185–186.UllyotDG]]NormanJCThe Fogarty catheter: an aid to bronchoscopic removal of foreign bodies.Ann Thorac Surg19686185-18621. Swanson KL. Airway foreign bodies: what’s new? Semin Respir Crit Care Med 2004;25:405–411.SwansonKLAirway foreign bodies: what’s new?Semin Respir Crit Care Med200425405-411
