Clinical trial NCT04988113: Presentation And Management Of Neglected Inhaled Foreign Body At Sohag University Hospital
Official title: Presentation And Management Of Neglected Inhaled Foreign Body At Sohag University Hospital
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Foreign Body; Inhalation
Lead sponsor: Sohag University
Sponsor class: OTHER
First posted: 2021-08-03
Enrollment: 60
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who were diagnosed with neglected inhaled foreign body who underwent bronchoscopy in sohag university hospital

Brief summary: Delayed presentation is not uncommon in children and may have been treated as asthma due to associated with low-grade cough and noisy breathing.

Late diagnoses of foreign body aspiration were defined as occurring beyond 3 days after the aspiration of the foreign body, or onset of symptoms.

Undiagnosed foreign body aspiration can cause mechanical effects, chemical reactions, and the most common complications were pneumonia, asthma, lung collapse, bronchiectasis, emphysema, mediastinal shift, atelectasis and lung abscess. Long-term presence of FBs in the bronchus may lead to bronchial stenosis

Detailed description: A foreign body is an endogenous or exogenous substance, different from the anatomy of the site where it is found. Chevalier Jackson defined a foreign body as "an object or a substance that is foreign to its location".

Aspiration of a foreign body (FB) is a potentially life-threatening emergency and 75% of cases occur in children younger than 3 years of age, due to the absence of molar teeth, underdeveloped swallowing coordination and the tendency to talk and play while eating .

However, foreign body aspiration does happen in adults and elderly people as well.

Obtaining a good history plays a vital role in effectively diagnosing a foreign body aspiration. Three clinical phases of aspiration of foreign bodies are recognized: The first stage is the impaction of the foreign body and entitled "penetration syndrome," defined as a sudden onset of choking and intractable cough with or without vomiting.

In the second stage, these symptoms diminish as the foreign body settles into a stationary location and the tracheoesophageal reflexes tire out; this asymptomatic stage can last hours to weeks, which may delay diagnosis. In the third phase, Complications occur (also defined as Complications phase), when obstruction, erosion or infection cause pneumonia, atelectasis, abscess or fever. The first presentation of the condition may actually represent a complication of inhaled foreign body.

Delayed presentation is not uncommon in children and may have been treated as asthma due to associated with low-grade cough and noisy breathing.

Late diagnoses of foreign body aspiration were defined as occurring beyond 3 days after the aspiration of the foreign body, or onset of symptoms.

Undiagnosed foreign body aspiration can cause mechanical effects, chemical reactions, and the most common complications were pneumonia, asthma, lung collapse, bronchiectasis, emphysema, mediastinal shift, atelectasis and lung abscess. Long-term presence of FBs in the bronchus may lead to bronchial stenosis.

Neglected foreign bodies in the respiratory tract may occur due to misdiagnosis by the fellow professionals and pediatricians when FBs in the upper tracheal airway produce symptoms similar to those of viral subglottic croup or due to lack of typical symptoms and signs. The most common symptoms and signs of FBA, namely coughing, wheezing, and decreased air entry, can easily be overlooked by bronchial asthma or pneumonia. Parental negligence, not conclusive chest radiographs, and false negative bronchoscopic findings are other blamed factors

Eligibility criteria: Inclusion Criteria:

Patients who were diagnosed with neglected inhaled foreign body who underwent bronchoscopy in sohag university hospital, all ages, both Gender.

Exclusion Criteria:

Patients who were diagnosed with recent inhaled foreign body.

Primary outcomes:
measure: Assessment of different pictures of clinical presentations in neglected inhaled foreign body.
timeFrame: 3 months from August to December 2021
measure: Determination of types of complications in neglected inhaled foreign body.
timeFrame: 3 months from August to December 2021
measure: Determination of different types of management plans in neglected inhaled foreign body.
timeFrame: 3 months from August to December 2021
Secondary outcomes:
Other outcomes:
Locations:
city: Sohag
country: Egypt
facility: Sohag University
Study officials:
affiliation: Sohag University
name: Abdel-Mateen M Abd ElLateef, professor
role: STUDY_CHAIR
References:
citation: Adjeso T, Damah MC, Murphy JP, Anyomih TTK. Foreign Body Aspiration in Northern Ghana: A Review of Pediatric Patients. Int J Otolaryngol. 2017;2017:1478795. doi: 10.1155/2017/1478795. Epub 2017 Oct 1.
citation: Lin L, Lv L, Wang Y, Zha X, Tang F, Liu X. The clinical features of foreign body aspiration into the lower airway in geriatric patients. Clin Interv Aging. 2014 Sep 24;9:1613-8. doi: 10.2147/CIA.S70924. eCollection 2014.
citation: Salih AM, Alfaki M, Alam-Elhuda DM. Airway foreign bodies: A critical review for a common pediatric emergency. World J Emerg Med. 2016;7(1):5-12. doi: 10.5847/wjem.j.1920-8642.2016.01.001.