The Clinical Analysis Of 320 Cases Of Tracheobronchial Foreign Bodies

Objective: To review the clinical records of 320 patients admitted for foreign body aspiration and investigate the most suspectable age, the most common foreign body, the most frequent site, radiological findings and misdiagnosis of foreign body aspiration.Materials and methods: The clinical records of 320 patients with a history suggestive of foreign body aspiration from Jan. 2000 to Dec. 2006 were retrospectively reviewed. The presence of tracheobronchial foreign body was confirmed in 295 patients by the examination of rigid bronchoscope and these 295 patients were further studied. The age of these patients ranges from 3 months to 69 years old (mean age 3.6 years old). Male children were at higher risk than females (193vs102). 250 patients were from countrysides while only 45 from cities. Most patients complained of the sudden onset with respiratory distress, cough, choking and fever. Decreased breath sound can be found in 196 patients. 252patients took the radiological examination before rigid bronchoscope examination. All patients had rigid bronchoscope examination.Result: In 58 patients chest X-rays were normal. Mediastinal swaying,localized air trapping and atelectasis were found in radiological examination in descending order of frequency. In 295 cases foreign body was removed successfully by rigid bronchoscope with immediate relief of symptoms while foreign bodies were notfound in 23 cases. In 1 case the foreign body was not removed successfully and in 1 case the patients died. The most common foreign body was peanuts (131 cases). Right and left bronchus had relatively equal incidence of foreign body aspiration (129 VS 116).Conclusion: From the study above, we can draw the conclusion as follows: Most of the patients were under 5 years old, with a peak incidence at the age of 1 or 2 years old. Peanut was the most common foreign body removed followed by sunflower seed. Most frequent site involved was bronchus. Right and left bronchus had relatively equal incidence of foreign body aspiration. Radiological findings before bronchoscopy have a high diagnostic value in foreign body aspiration. There is a high frequence of misdiagnosis of tracheobronchial foreign body aspiration.