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Paediatric bronchoscopy.

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F Ratjen, T Nicolai. 2004. Paediatric bronchoscopy.. https://doi.org/10.1016/s1526-0542(04)90004-8

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Fibrobronchoscopic treatment of foreign body aspiration in children: an experience of 5 years in Hangzhou City, China.

OBJECTIVE: The aims of the study were to evaluate duration of symptoms, clinical manifestation, radiological findings, fibrobronchoscopic findings, and the complications of airway foreign body (FB). METHODS: A retrospective review of 304 children who had airway FB removed via fibrobronchoscopy from January 1997 to June 2003 was conducted in the Children's Hospital of Zhejiang University School of Medicine, China. Two hundred eight boys and 96 girls were included. Their ages ranged from 2 months to 11 years, and the median was 18 months. RESULTS: Three patients died; 81.24% of the patients had a history of FB aspiration, and the most frequent clinical manifestation was paroxysmal coughing (89.25%). Positive radiological findings were found in 90.13% of patients, and the most common type of FB was peanut (35.53%). Serious complication of lung was found in 65 patients, and the associated factors were age, sex, and times of fibrobronchoscopy and location of FB in the right or left lung. CONCLUSIONS: FB aspiration remains a major cause of morbidity and mortality in childhood. Education aimed at increasing diagnostic acumen of the physicians and heightening of public awareness are the most important steps needed to reduce the morbidity and mortality.

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Endobronchial migration of prosthetic patch after congenital diaphragmatic hernia repair.

Surgical repair of congenital diaphragmatic hernia (CDH) can be performed by means of either direct suturing of the diaphragm or positioning of a prosthetic patch. However, half of all prosthetic patches show evidence of reherniation. We describe the case of an 8-year-old girl who presented with prosthesis dislocation and fistulization in the right lower bronchus as a complication of a CDH repair that she underwent when she was 1 year old. Abdominal ultrasound and magnetic resonance imaging suggested a hernia relapse, whereas chest computed tomographic scan failed to identify the diaphragmatic defect. Only fibrobronchoscopy allowed fistulization of the prosthesis into the bronchi to be correctly diagnosed.

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