Tracheobronchial Foreign Body Extraction in a Preterm Infant via Choledochoscope: A Case Report and Literature Review.

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2025-08-01 Epub Date: 2025-04-26 DOI:10.1177/00034894251336540

Ratko Prstačić, Miram Pasini, Nada Sindičić Dessardo, Mateja Đenović, Ruža Grizelj

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引用次数: 0

Abstract

Objectives: Tracheobronchial foreign body (TFB) extraction in premature neonates poses unique challenges due to their delicate respiratory system, making the TBF extraction a critical and high-stakes intervention. TFBs in this patient population are mostly iatrogenic. There are only a few reports in the literature describing the management of TFBs in premature neonates. To the best of our knowledge, this represents the first report using a flexible choledochoscope for TFB extraction.

Methods: A retrospective chart review was conducted on a case of a preterm infant who underwent successful extraction of a tracheobronchial foreign body.

Results: A premature neonate born at 25 weeks 2/7 days gestation with a birth weight of 780 g was intubated after delivery. Following extubation to non-invasive ventilation, a control chest radiograph revealed atelectasis of the right lower lobe and a TFB of tubular structure measuring 20 mm × 1.5 mm in the right main bronchus. Diagnostic flexible bronchoscopy was performed and extraction with graspers via rigid bronchoscope was attempted but failed. Subsequently, a bedside procedure in the Neonatal intensive care unit (NICU) was performed using a 7.5 Fr flexible choledochoscope through the endotracheal tube (ETT). TFB was successfully extracted with graspers and upon extraction, it was confirmed to be the distal 2 cm segment of the closed-circuit endotracheal suction system. The infant made full recovery.

Conclusion: We report a method that provides a safe means of TFB extraction with a successful outcome. The insights gathered from this review are intended to contribute valuable knowledge that can enhance the management of TFBs in preterm infants.

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早产儿经胆道镜气管支气管异物取出1例并文献复习。

目的：由于早产儿呼吸系统脆弱，气管支气管异物（TFB）的取出面临着独特的挑战，使TBF取出成为一项关键和高风险的干预措施。该患者群体中的tbs大多是医源性的。文献中只有少数报道描述了早产儿tbs的管理。据我们所知，这是第一个使用柔性胆道镜提取TFB的报告。方法：回顾性分析1例早产儿气管支气管异物取出术成功的病例。结果：1例妊娠25周2/7天，出生体重780 g的早产新生儿在分娩后插管。拔管至无创通气后，对照胸片显示右下肺叶不张，右主支气管管状结构TFB大小为20 mm × 1.5 mm。进行了诊断性的柔性支气管镜检查，并尝试通过刚性支气管镜用夹持器取出，但失败了。随后，在新生儿重症监护病房（NICU）使用7.5 Fr柔性胆道镜通过气管内管（ETT）进行床边手术。用抓钳成功拔出TFB，拔出后确认为闭路气管内吸引系统的远端2cm段。婴儿完全康复了。结论：我们报告了一种安全的TFB提取方法，并取得了成功的结果。从本综述中收集的见解旨在为加强早产儿tbs的管理提供有价值的知识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.