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Revista chilena de pediatría

versión impresa ISSN 0370-4106

Resumen

PRADO A., Francisco et al. Obstrucción de la vía aérea por cuerpo extraño: Manejo endoscópico combinado. Rev. chil. pediatr. [online]. 1999, vol.70, n.5, pp.398-404. ISSN 0370-4106.  http://dx.doi.org/10.4067/S0370-41061999000500006.

21 patients admitted to San Borja Arriaran Hospital between January 1996 and June 1999 were analized. Clinical suspicion of foreign body aspiration (FBA) was present in 8 patients, aged 18 months to 15 years ( mean 6 yrs 7 months). 2 of them choked while eating and in the remaining children chest x-ray revealed atelectasis. Fiberoptic bronchoscopy (FB) was performed in all of them. A mucus plug was found in 3, and the airway was normal in another 3 patients. 3 patients had a combined procedure with rigid bronchoscopy that permitted the removal of the foreign body in 2 cases. Clinical diagnosis of FBA was done in 13 patients, aged 8 months to 8 years (mean 3 yrs 8 months), 10 boys, 3 girls. All of them choked while eating or playing, 6 had respiratory failure, 1 with a cardiorespiratory arrest. 2 had severe upper airway obstruction, and a normal physical examination in 6. Nine patients underwent the combined procedure (rigid and FB) to localize and remove the foreign body, located supracharinal in 5 (36%) and endobronchial in 9 (64%). In 2 patients the foreign body was removed using laryngoscopy and a Magill forceps, 1 required FB with a stone basket catheter to remove a distally migrated multi-fragmented vegetal foreign body. 5 (36%) of foreign bodies were radio-opaque. FBA should be highly suspected in children choking while eating or playing with small toys. Physical examination and the chest x-ray may be normal, therefore visualization of the airway is strongly recommended. The combined procedure allows a more thorough and less traumatic exploration, to remove vegetables or distally placed foreign bodies. Prevention must be orientated to modify alimentary habits and avoid playing with toys that contain small parts in children under 5 yrs

Palabras clave : Foreign body; airway; bronchoscopy.

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