| Objective:To explore common cause of bronchial foreign body, clinical manifestation, radiculopathy features and the misdiagnosis,in order to help the clinical doctors to raise rate of diagnose of the bronchial foreign body.Methods:The data of 11 patients of bronchial foreign body who were treated in run hospital since January 2006 to December 2010 were collected. Their data of clinical manifestations, physical examination, laboratory examination, imaging features and fiberoptic bronchoscopy examination were retrospectively analyzed and data of some documents were retrospectively analyzed.Results:There were 6 males and 5 females in 11 patients, aged 20-76 years with mean age of 63.20 years(ranging from 20 to 76 years). Each of the 11 patients had symptoms of cough,7 patients had vomica,5 patients had history of hemoptysis,9 patients had chest tightness and shortness of breath,7 patients had fever and chilly,8 patients had Abnormal respiratory sounds,3 patients had absence of physical signs.The longest case history before in hospital was of up to 12 months, the shortest case history was of 1 day, average case history was of 4.5 months. A clear history of foreign body aspiration in 5 cases, suspected foreign body aspiration in 3 cases,3 patients denied foreign body aspiration. The longest time of misdiagnosis was of 12 months. Imaging:bronchial foreign body was showed in chest X-ray in 2 cases, was showed in chest CT in 4 cases.Signs of lung infection was showed in 5 cases, signs of lung mass with obstructive pneumonia was showed in 1 case, no foreign body was showed in 5 cases. Each of the 11 patients was examined with bronchoscopy, the results showed:1 case of foreign body in trachea, right main bronchus in 6 cases,4 cases of left main bronchus. Various types of foreign bodies:1 foreign body is about 4cm whole shrimp, and 2 were about 5mm of bone-like,1 case of the lobster to be 5cm long, and 1 was 2cm head of the prawn,1 thermometer,1 fish spine,1 small walnut shell,1 turtle bone,1 case of peas,1 case of peanuts.11 cases of foreign bodies in this group were removed through mouth by branchofiberoscope,10 patients were removed the foreign body in first checking up. No foreign body was found patient were only found left main bronchial lumen completely blocked 1 caused by granuloma, frozen and argon knife combination therapy, 3 days after fiberoptic bronchoscopy again and found a foreign body forceps.Conclusion:Most bronchial foreign body occurs children and the elder, symptoms of the disease urgent, serious and complications, easily misdiagnosed. Diagnosis should mainly rely on history, symptoms, signs and X-ray, Foreign bodies sucked history and the foreign bodies X-ray image are very important for diagnosis of clinical misdiagnosis Children, the elder and patients with unconsciousness coused by stroke, metabolic encephalopathy, alcoholism, depressants used excessive etc. cannot provide explicit foreign history, part of adult sometimes can't clear whether had couged up the foreign body. Secondary infection, pneumothorax, atelectasis caused by bronchial jams further hide the condition of the illness. Chest X-ray are very poorly for the specificity of the bronchial foreign body diagnosis. It always are misdiagnosed as pneumonia, tuberculosis, bronchus lung cancer. Lung CT, spiral CT examination can effectively reduce the occurrence of misdiagnosis or missing. Fiberoptic bronchoscopy is the important means of diagnosis and treatment for bronchial foreign body. |
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