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. 2014 Sep 24:9:1613-8.
doi: 10.2147/CIA.S70924. eCollection 2014.

The clinical features of foreign body aspiration into the lower airway in geriatric patients

Lianjun Lin  1 , Liping Lv  2 , Yuchuan Wang  1 , Xiankui Zha  2 , Fei Tang  2 , Xinmin Liu  1
Affiliations

The clinical features of foreign body aspiration into the lower airway in geriatric patients

Lianjun Lin et al. Clin Interv Aging. .

Abstract

Purpose: To analyze the clinical features of foreign-body aspiration into the lower airway in geriatric patients.

Patients and methods: The clinical data of 17 geriatric patients with foreign-body aspiration were retrospectively analyzed and compared with 26 nongeriatric adult patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2000 and June 2014.

Results: (1) In the geriatric group, the most common symptoms were cough and sputum (15 cases, 88%), dyspnea (six cases, 35%), and hemoptysis (four cases, 24%). Five patients (29%) in the geriatric group could supply the history of aspiration on their first visit to doctor, a smaller percentage than in the nongeriatric group (13 cases, 50%). Only three cases in the geriatric group were diagnosed definitely without delay. Another 14 cases were misdiagnosed as pneumonia or lung cancer, and the time of delayed diagnosis ranged from 1 month to 3 years. Complications due to delay in diagnosis included obstructive pneumonitis, atelectasis, lung abscess, and pleural effusion. (2) Chest computed tomography demonstrated the foreign body in three cases (21%) in the geriatric group, which was lower than the positive proportion of detection in the nongeriatric group (nine cases, 35%). The most common type of foreign body in the geriatric group was food, such as bone fragments (seven cases, 41%) and plants (seven cases, 41%), and the foreign body was most often lodged in the right bronchus tree (eleven cases, 65%), especially the right lower bronchus (seven cases, 41%). Flexible bronchoscopy removed the foreign body successfully in all patients.

Conclusion: The clinical features of foreign-body aspiration in geriatric patients are usually more obscure than in nongeriatric adults, which may lead to long delay in diagnosis. Flexible bronchoscopy is safe and useful for early diagnosis and effective management in geriatric patients. We suggest flexible bronchoscopy as the first-line approach to similar patients, especially those with aspiration history and unexplained pneumonia.

Keywords: airway foreign-body aspiration; flexible bronchoscopy; geriatric patients.

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Figures

Figure 1
Figure 1
The presentation of airway foreign bodies (chicken bones and fish bones). Notes: Chest computed tomography (A), bronchoscopy (B), and photographs of the foreign bodies (C).
Figure 2
Figure 2
The presentation of airway foreign bodies (chili, pea, melon seed, and sunflower seed). Notes: Chest computed tomography (A), bronchoscopy (B), and photographs of the foreign bodies (C).
See this image and copyright information in PMC

References

    1. Boyd M, Chatterjee A, Chiles C, Chin R., Jr Tracheobronchial foreign body aspiration in adults. South Med J. 2009;102(2):171–174. - PubMed
    1. Hsu WC, Sheen TS, Lin CD, Tan CT, Yeh TH, Lee SY. Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: a series of 3,217 cases from 1970 to 1996. Otolaryngol Head Neck Surg. 2000;122(3):450–454. - PubMed
    1. Baharloo F, Veyckemans F, Francis C, Biettlot MP, Rodenstein DO. Tracheobronchial foreign bodies: presentation and management in children and adults. Chest. 1999;115(5):1357–1362. - PubMed
    1. Chen CH, Lai CL, Tsai TT, Lee YC, Perng RP. Foreign body aspiration into the lower airway in Chinese adults. Chest. 1997;112(1):129–133. - PubMed
    1. al-Majed SA, Ashour M, al-Mobeireek AF, al-Hajjaj MS, Alzeer AH, al-Kattan K. Overlooked inhaled foreign bodies: late sequelae and the likelihood of recovery. Respir Med. 1997;91(5):293–296. - PubMed

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