Author/Editor		Debeljak, Andrej; Šorli, Jurij; Kecelj, Peter
Title		Tujki v bronhijih. Naše izkušnje s 33 bolniki od 1988 do 1997
Translated title		Bronchial foreign bodies - Our experience with removal in 33 patients, 1988-1997
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 3, št. 7
Publication year		1998
Volume		str. 179-83
Language		slo
Abstract		Background. A 10-year experience with the removal of bronchial foreign bodies is presented. Patients and methods. Retrospectively, we examined the patients' and bronchoscopic records, and the collection of foreign bodies at the Department of Pulmonary Diseases and Allergy Golnik. Removal of bronchial foreign bodies was accomplished in 30 adults aged 30 to 80 years (mean 57+-15 yrs), and 3 children aged 6, 10 and 13 years. There were 24 males and 9 females. Topical anaesthesia was induced with lidocaine. Fentanyl was added intravenously when the rigid bronchoscope was used. Foreign bodies were removed by flexible bronchoscopy in 27 patients (82%), and by rigid bronchoscopy in 5 patients (15%). In one case (3%) we were unable to remov ethe foreign body despite the use of both types of instruments. Results. The indications for bronchoscopy in our series included a suspected foreign body in 21 patients, lung tumour in 9 and pneumonia in 3. Chest x-rays showed pneumonia in 20 patients, foreign body in 7 and atelectasis in 3 patients. Three patients had normal radiographic findings. In 1 patient, 2 foreign bodies were removed. The foreign bodies removed from the bromchi included 15 pieces of bone, 5 pieces of teeth, 4 cherry stones, 3 pices of plastics, 2 pea grains, a bean seed, an apple pip, an endodontic needle and a piece of palstic wrapping with a metallic skewer of a salami. We were unable to remove a metallic fragment situated in the lung for 27 years. The biopsy forceps, the wire basket and the alligator forceps were found to be the most suitable instruments for removing foreign bodies. Conclusion. Bronchial foreign bodies in adults are rare and mostly removed with the flexible bronchoscope. The rigid instrument, however, is preferred for extracting large foreign bodies from the central bronchi.
Summary		Izhodišča. Prikazujemo svoje izkušnje z odstranjevanjem tujkov iz bronhijev v zadnjih 10 letih. Bolniki in metode. Retrospektivno smo pregledali bolniško dokumentacijo, bronhoskopske izvide ter zbirko tujkov v Kliničnem oddelku za pljučne bolezni in alergijo Golnik. Tujke smo odstranjevali pri 30 odraslih, starih 57 +/- 15 let (od 30 do 80 let), in pri 3 otrocih starih, 6, 10 in 13 let. Štiriindvajset bolnikov je bilo moškega in 9 ženskega spola. Uporabljali smo lokalno anestezijo z lidokainom. Če smo uporabljali togi bronhoskop, smo dodajali v veno fentanil. Tujek smo odstranili z upogljivo bronhoskopijo pri 27 bolnikih (82%), s togo bronhoskopijo pa pri 5 bolnikih (15%). Pri enem bolniku (3%) nismo mogli odstraniti tujka, čeprav smo uporabili oba bronhoskopa. Rezultati. Bolniki so prišli na bronhoskopijo zaradi suma na tujek v bronhiju (n=21), pljučni tumor (n=9) ali pljučnico (n=3). Rentgenska slika pljuč je pokazala pljučnico (n=20), tujek (n=7), atelektazo (n=3) ali pa je bila slika normalna (n=3). Pri enem bolniku smo odstranili dva tujka. Iz bronhijev smo odstranili košček kosti (n=15), del zoba (n=5), češnjevo koščico (n=4), košček plastike (n=3), zrno graha (n=2) in po eno zrno fižola, jabolčno peško, endodontsko iglo, kovinsko špilo z delom plastičnega ovitka salame. Košček kovine, ki je ležal v pljučih 27 let, pa nismo uspeli odstraniti. Najuspešnejši inštrumenti, s katerimi smo odstranili tujke, so bili: biopsijske kleščice, žična košarica ter krokodilske kleščice. Zaključek. Tujki v bronhijih odraslih so redki. Večino jih lahko odstranimo z upogljivim bronhoskopom. Velike tujke v večjih bronhijih je laže odstraniti s togim bronhoskopom.
Descriptors		FOREIGN BODIES BRONCHOSCOPY LUNG DISEASES PNEUMONIA, ASPIRATION