Dr. Charu Tiwari
All India Institute of Medical Sciences, Raipur, CG, India
Title: Tamarind Seeds in Tracheo-Bronchial Tree: Technical Challenges During Rigid Bronchoscopy
Biography
Biography: Dr. Charu Tiwari
Abstract
Background: Foreign body aspiration is very common among pediatric population. Removal of these foreign bodies, especially the vegetable organic ones, could be quite challenging. These vegetable foreign bodies account for approximately 60-70 percent of all aspirated foreign bodies in children. These foreign bodies usually get swollen and become difficult to remove through rigid bronchoscopy. With this Background, we describe four cases of old aspirated tamarind seeds who presented to us and all the challenges faced during bronchoscopy and their removal.
Methods Four patients who presented to our Pediatric Surgery Department with history of aspiration of tamarind seed (vegetable foreign body) for more than one week duration in the past 4 years are described along with the challenges faced during bronchoscopy and their removal.
Rescue us: Four pediatric patients with old history of aspirated tamarind seeds are described. All four patients presented with mild tachypnea at room air on admission. However, saturation was maintained in all four of them. The diagnosis was confirmed with HRCT Thorax in all. All four patients underwent rigid bronchoscopy with appropriate size brioche scope under General Anesthesia. The foreign body (tamarind seed was found impacted and swollen during removal- 3 in right main stem bronchus and one in left main stew bronchus. The optical forceps were used for removal. The tamarind seeds were swollen and hence could not be retrieved in toil in two patients. Hence, the seeds were broken and removed in pieces in these two patients. In the other two patients, tracheosloiny was required as the swollen seeds could not be negotiated through the narrow subglottic.
All had uneventful post-operative course and were discharged.
Conclusion: Bronchoscopy removal of vegetable foreign body from the tracheobronchial tree is challenging. Anticipating the difficulty and being prepared well will reduce intraoperative difficulty and allow successful removal with favorable patient outcomes. The operating surgeon should take consent for tracheostomy and have an lracheostoiny instrument set and appropriate sized tracheostomy tubes ready during the procedure to minimize the complications and ensure better outcome.