Presentation And Management Of Neglected Inhaled Foreign Body At Sohag University Hospital

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

Study Overview

• Status: Recruiting
• Conditions: Foreign Body; Inhalation

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

• Study Type: Observational
• Enrollment (Anticipated): 60

Contacts and Locations

• Study Contact: Name: Abdallah M Ahmed, resident; Phone Number: 01098720110; Email: abdallah.ahmed@med.sohag.edu.eg
• Study Contact Backup: Name: Mostafa A Mohamed, professor; Phone Number: 01032713236

Study Locations

• Egypt
  • Sohag, Egypt
    • Recruiting
    • Sohag University
    • Contact: usama R El-Sherif, professor

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients who were diagnosed with neglected inhaled foreign body who underwent bronchoscopy in sohag university hospital

Description

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.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Retrospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of different pictures of clinical presentations in neglected inhaled foreign body.	This is a retrospective study that will be conducted in our tertiary center "Sohag University Hospital", will include cases of neglected inhaled foreign bodies in the period from June 2016 to June 2021, the medical records of patients who underwent bronchoscopy for suspected neglected foreign body aspiration will be reviewed. Assessment of different pictures of clinical presentations by reviewed symptoms and signs for the cases.	3 months from August to December 2021
Determination of types of complications in neglected inhaled foreign body.	This is a retrospective study that will be conducted in our tertiary center "Sohag University Hospital", will include cases of neglected inhaled foreign bodies in the period from June 2016 to June 2021, the medical records of patients who underwent bronchoscopy for suspected neglected foreign body aspiration will be reviewed. Determination of types of complications in neglected inhaled foreign body.	3 months from August to December 2021
Determination of different types of management plans in neglected inhaled foreign body.	This is a retrospective study that will be conducted in our tertiary center "Sohag University Hospital", will include cases of neglected inhaled foreign bodies in the period from June 2016 to June 2021, the medical records of patients who underwent bronchoscopy for suspected neglected foreign body aspiration will be reviewed. Determination of different types of management plans by rigid or flexible bronchoscopic findings, including the type and the location of the foreign body	3 months from August to December 2021

Collaborators and Investigators

• Sponsor: Sohag University
• Investigators: Study Chair: Abdel-Mateen M Abd ElLateef, professor, Sohag University

Publications and helpful links

General Publications

• 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.
• 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.
• 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.

Study record dates

Study Major Dates

• Study Start (Anticipated): August 1, 2021
• Primary Completion (Anticipated): December 1, 2021
• Study Completion (Anticipated): December 1, 2021

Study Registration Dates

• First Submitted: July 13, 2021
• First Submitted That Met QC Criteria: July 23, 2021
• First Posted (Actual): August 3, 2021

Study Record Updates

• Last Update Posted (Actual): August 3, 2021
• Last Update Submitted That Met QC Criteria: July 23, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Foreign Bodies
• Other Study ID Numbers: Soh-Med-21-07-14

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No