Mustafa İNAN, Çağatay Yalçın AYDINER, Burhan AKSU, Mehmet PUL

Çocukluk çağında trakeobronşiyal yabancı cisim aspirasyonları

Amaç: Trakeobronşiyal yabancı cisim aspirasyonu şüphesi ile acil servise getirilen hastaların tanı ve tedavi yöntemlerinin değerlendirilmesi. Yöntem: Kasım 1996 ve Temmuz 2004 döneminde yabancı cisim aspirasyonu şüphesiyle bronkoskopi yapılan 26 hasta geriye dönük bir çalışmayla incelendi. Tanı öykü, fizik bakı, radyolojik yöntemler ve bronkoskopik inceleme ile konuldu. Bulgular: Vakaların 11'i erkek ve 15'i kız çocuğuydu. Hastaların yaşları 8 ay ile 14 yaş arasındaydı (ortalama 44.7±52.9 ay). Yabancı cisim 10 vakada sağ ana bronş, 3 vakada sol ana bronş ve 7 vakada trakea yerleşimliydi. Altı vakada yabancı cisime rastlanmadı. Çıkartılan yabancı cisimlerin büyük çoğunluğu organik maddelerdi (n=15). Radyolojik incelemelerde yalnızca bir vakada yabancı cisime ait opasite, diğerlerinde ise indirekt bulgular saptandı. Tüm vakalarda torakotomi gerekmeksizin bronkoskopi ile yabancı cisim çıkartıldı. Bir vakada operasyon sırasında pnömotoraks gelişti. Sonuç: Trakeobronşial yabancı cisim aspirasyonlarında genellikle indirekt radyolojik bulgular gözlenmektedir. Genel anestezi altında yapılan bronkoskopi en etkili tanı ve tedavi yöntemidir.

Anahtar Kelimeler:

Çocuk, Geriyedönük çalışma, Bronkoskopi, Yabancı cisimler

Tracheobronchial foreign bodies in children

Aim: Assessment of diagnostic and therapeutic approach in patients with tracheobronchial foreign body aspiration in childhood. Method: The patient who had admitted to our emergency department between November 1994 and July 2004 were retrospectively analyzed. Diagnostic methods were patients' medical history, physical examination, radiological procedures and bronchoscopy. Results: 26 patients (11 males, 15 females) with an age distribution of 8 months to 14 years (average 44.7±52.9 months) were evaluated. Localizations of foreign bodies were; right main bronchus (n=10), left main bronchus (n=3) and trachea (n=7). No foreign bodies were found in 6 patients. Radiological investigations revealed opacity in only one patient, the remaining patients had indirect findings of foreign body. Most of the foreign bodies were organic in nature (n=15). None of the patients required thoracotomy. The only complication of bronchoscopic intervention was pneumothorax in one patient. Conclusion: Tracheobronchial foreign body aspirations usually present with indirect radiological findings. Bronchoscopy under general anesthesia is the choice of diagnostic and therapeutic method.

Keywords:

Child, Retrospective Studies, Bronchoscopy, Foreign Bodies,

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