Pradipta KUMAR PARİDA, Nirmal SHANMUGASUNDARAM, Surianarayanan GOPALAKRİSHNAN

Çocuklarda yabancı cisim aspirasyonu erken tanısını öngören klinik-radyolojik parametreler

Amaç: Bu çalışmada çocuklarda yabancı cisim YC aspirasyonu erken tanısı için klinik ve radyolojik bulgular araştırıldı.Hastalar ve Yöntemler: Bu prospektif çalışma Eylül 2010 - Mayıs 2014 tarihleri arasında, YC aspirasyonu klinik tanısı ile rijid bronkoskopi uygulanan 12 yaşından küçük 45 çocuk ile yürütüldü. Otuz yedi YC pozitif çocuğun sonuçları 22 erkek, 15 kız; ort. yaş 2.6 yıl; dağılım 1-12 yıl bronkoskopi ile analiz edildi.Bulgular: Penetrasyon sendromu ani başlangıçlı öksürük, boğulma ve tıkanma %89.2 ve azalmış solunum sesleri %86.5 en sık görülen klinik özelliklerdi. Öksürük, solunum zorluğu ve ateş sırasıyla %83.8, %78.4 ve %27 idi. Takipne, taşikardi, göğüs çekilmeleri, azalmış göğüs hareketleri ve hırıltı sırasıyla %83.3, %83.3, %83.3, %51.4 ve %43.2 idi. Tek taraflı hiperinflasyon %64.9 , mediastinal şift %45.9 ve çökme %21.6 akciğer grafisinde ve göğüs röntgenlerinde ortak radyolojik bulgulardı ve hastaların %13.5’inin akciğer filmi normaldi. Yabancı cisim yerleşim yerleri gırtlak, soluk borusu, sağ ana bronş, sol ana bronş ve iki taraflı bronşlarda sırasıyla %10.8, %10.8, %35.1, %37.8 ve %5.5 idi. Gıda ile ilgili YC’ler 30 olguda yer fıstığı %54.1 ve inorganik YC yedi olguda mevcuttu.Sonuç: Penetrasyon sendromu, lokalize solunum sesleri azalması, tek taraflı hiperenflasyon veya radyolojide mediastinal şift YC aspirasyonu erken tanısı için gösterge niteliğindedir

Anahtar Kelimeler:

Bronkoskopi, bronş, yabancı cisimler, yabancı cisim aspirasyonu

Clinico-radiological parameters predicting early diagnosis of foreign body aspiration in children

Objectives: This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body FB aspiration in children. Patients and Methods: This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children 22 males, 15 females; mean age 2.6 years; range 1 to 12 years with positive for FB on bronchoscopy were analyzed. Results: Penetration syndrome sudden onset coughing, choking and gagging 89.2% and decreased breath sounds 86.5% were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation 64.9% , mediastinal shift 45.9% , and collapse 21.6% were common radiological signs on chest radiography and in 13.5% patients the chest X-rays were normal. Sites of FB lodgements were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases peanut 54.1% and inorganic FBs were present in seven cases. Conclusion: Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.

Keywords:

Bronchoscopy, bronchus, foreign bodies, foreign body aspiration,

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