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Title: BEAD IN TRACHEOBRONCHIAL TREE: A THERAPEUTIC CHALLENGE
Authors: Naseer Ahmad, Ihsan Ullah, Muhammad Javaid, Muhammad Habib Khattak
Journal: Journal of Postgraduate Medical Institute
Publisher: Postgraduate Medical Institute
Country: Pakistan
Year: 2006
Volume: 20
Issue: 3
Language: English
Keywords: Foreign bodyBronchoscopyTracheostomyThoracotomyBead
Objective: To find out management strategy of bead as a foreign body in tracheobronchial tree.Material and Methods: We managed thirty children having bead in tracheobronchial tree. As most ofthem were in respiratory distress, they were treated on emergency basis. On bronchoscopy, due to roundedand slippery nature of the bead, the extraction is not possible with ordinary forceps. But due to a smallhole inside the bead, we were able to pass a minute forceps into this hole and upon opening the prongs ofthis forceps, beads were extracted. In case of failure, tracheostomy was done or help of cardiothoracicsurgeon for thoracotomy was sought.Results: Our study consists of thirty children having bead in tracheobronchial tree. Males were 18 (60%)and females were 12(40%). Fifteen (50%) patients were in between 6-8 years. Twenty five (83.3%) childrencame within 24hours after bead inhalation. In about 18(60%) cases foreign body was lying in trachea.Beads were removed through bronchoscopy in 25 (83.3%) cases, while 3(10%) beads were removedthrough tracheostomy and 2(6.6%) beads were openly removed through thoracotomy. Mortality was nilwhile morbidity was found in 5(16.6%) cases.Conclusion: Foreign body in tracheobronchial tree can be managed easily with the present bronchoscopictechnique and special extraction instruments but bead is still a challenging foreign body and at times needfurther surgical options like tracheostomy or thoracotomy.
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