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Article
Rigid Versus Flexible Bronchoscopy in the Diagnosis of Carcinoma of the Lung

Author: Nazar B. Elhassani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2008 Volume: 7 Issue: 3 Pages: 192-195
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:OBJECTIVE:The aim of the study is to evaluate the role of both the flexible and the rigid bronchoscopy in the diagnosiscarcinoma of the lung according to our present experience.METHODS:192 cases of carcinoma of the lung in whom diagnosis was established histopathologically or cytologically and for whom bronchoscopy, rigid or flexible was performed to establish diagnosis or to assess operability, have been studied.RESULTS:Out of the 104 patients examined by flexible bronchoscopy, histopathological or cytological diagnosis was established in 72 patients (69.23%). Intrabroncheal tumor was visualized in 52 patients (50%). Biopsy was taken in 49 out of these 52 patients and was positive in 43 patients (87.75%).Out of the 88 patients examined with rigid bronchoscopy histopathological or cytological diagnosis was established in 62 patients (70.45%). Intrabroncheal tumor was visualized in 40 patients (45.45%). Biopsy was taken in all these 40 patients and it was positive in 39 patients (97.5%).CONCLUSION:The study showed that the two modalities of bronchoscopy were safe and almost with the same diagnostic capability, with the flexible bronchoscopy having more extended scope of vision while the rigid one having better and more accurate biopsies.


Article
Traumatic Rupture of the Left Main BronchusCase report & review of the literatures

Author: Waleed M.Hussen
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 4 Pages: 484-486
Publisher: Baghdad University جامعة بغداد

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Abstract

Rupture of the trachea or main bronchus can occurs during severechest trauma and this event has been reported since more than acentury. This is a report of a 19 year old male patient sustained car accident leading to loss of consciousness due to multiple trauma ,involving specially the head and the chest that he needs assisted ventilation in an intensive care unit and later a tracheostomy .The patient regain his consciousness gradually , and a late diagnosis of traumatic rupture of the left main bronchus , which was approved by bonchoscopy and CT chest .Surgical repair of the ruptured left main bronchus was accomplished sixty days from the admission with the lung fully expanded on a post operative chest X-ray . The patient referred later to the ENT Department , thereafter a successful weaning from the tracheostomy was performed .The patient discharged well , but he was in need for regular bronchoscopic dilatation for a tracheal stricture as a complication of tracheostomy .The patient is still well during the follow up period .The report will includes a review of the literatures about thisrelatively uncommon post traumatic condition.

Keywords

Bronchoscopy --- CT chest.


Article
Foreign Bodies Inhalation

Author: Abdulameer M. Hussain
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 254-257
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: foreign bodies Inhalation still a common problem in Iraq, occurring in both lay and professional segments of our society. Their successful removal is based on a collected experience of our thoracic surgical teams.
Patients&Methods: A prospective study of two hundred forty eight patients referred to the department of thoracic surgery of the surgical subspecialties hospital of the medical city teaching complex during the year (2007) due to witnessed or suspicion of foreign body inhalation. Patients were grouped into group 1 with definite history of foreign body inhalation and group 2 with no such history.
Results: In group 1, out of 203(81.85%) patients, about 169(83.25%) patients were proved to have foreign body inhalation by rigid bronchoscopy, while in group 2,foreign body inhalation were proved in 14(31.11%) patients out of 45(18.14%) patients. The commonest age group of foreign body Inhalation was 6 months - two years (63.93%), and males to female ratio was 1.8:1. The highest peaks were encounter in July and August. The results of chest X-ray were normal in (53.55%) of cases and the most common radiological abnormality was pneumonic consolidation which was seen in (15.84%) of cases. Organic foreign bodies were representing (86.3%), the commonest organic foreign body was watermelon seed (48.65%), and the common site of foreign body lodgment was the right main bronchus.
Conclusion: The mere suspicion of a foreign body Inhalation is a justification for bronchoscopy. A negative bronchoscopy is better than to leave it inside with its serious sequels.

Keywords

Foreign body --- FB --- Bronchoscopy


Article
Foreign Body Aspiration in Children

Authors: Firas Shakir Al-Fahham1 --- Khalid Khaleel Al–Araji2 --- Hasan Mohammed Ridha AL- Qazzaz
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1771-1779
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: foreign bodies aspiration in children is a common emergency condition especially in less than 3 years old, comprising an important proportion of accidental deaths. Usually, there is a suggestive history of choking. The evolution of foreign body aspiration can lead to variable degrees of respiratory distress, serious respiratory complications, and even death. Early rigid bronchoscopy is a very effective procedure for definite diagnosis and removal of aspirated foreign body with fewer complications.Aim of study: To discuss causes and types of foreign body aspirationand effectiveness of bronchoscopy in children.Patients and Method: In Al-Hussein Medical City Hospital, bronchoscopy had been performed to 254 patients with the diagnosis of foreign body aspiration (from 2005 to 2012). Of which, 152 (59.85%) were males and 102 (40.15%) were females. Their ages ranged from 6 months to 10 years. Diagnosis had been established depending on history, physical examination, radiological studies and bronchoscopy.Results & Discussion: Foreign bodies (FBs) were removed by rigid bronchoscope. The sites of FBs were distributed in the following pattern: at the right main bronchus in 129 (50.79%) patients, at the left main bronchus in 55 (21.65%) patients, at the trachea in 38 (14.96%) patients, at the larynx in 16(6.3%) patients, and both bronchi in 4 (1.57%) patients. No foreign body could be found in 12 (4.73%) cases. The majority of the FBs were seeds 155 (61.02%). Pneumonia occurred in only 8(3.14%) patients.Foreign body aspiration is frequently encountered in pediatric practice. the condition is often not diagnosed immediately because there are no specific clinical manifestations. the ages 1 to 3 years were predominantly affected. The most common foreign body inhaled, Symptoms, most frequent age, and type of inhaled foreign body are different from region to region across the world. Foreign body aspiration was misdiagnosed by physician as pneumonia, asthma, bronchiectasis and bronchiolitis. Their definite diagnosis and treatment were provided by bronchoscopy, which was resorted to after unresponsiveness to previous treatment.Conclusion: Rigid bronchoscopy is very effective procedure to remove aspirated FBs with fewer complications.


Article
Foreign Body Inhalation in Pediatric Age Group

Authors: Wissam Kadhum Abdel Amer --- Adil Hadi Salih Al-Azzawi --- Ahmed Kareem Shiaan Al-Baidhani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 392 -397
Publisher: Babylon University جامعة بابل

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Abstract

Bronchoscopic removal of foreign body inhalation is treatment of choice. Development of anesthesia and endoscopic techniques supported by finer ,purposeful instruments and better understanding of the problems made the management easier, safer and surer and mortality claimed to be 1-2% compare to 50% before advent of endoscopy until 1800 foreign body inhalation removed by bronchotomy.over period of 2 years 2012-2014, 230 patient below 5 years received at our department to do bronchoscopy ,190 have definite history of foreign body inhalation proved by bronchoscopy , 40 cases suspected inhalation with persistence of chest infection.The most frequent affected group by foreign body inhalation 5 monthes-2 yearsmale to female ratio 1.8-1 most patient have definite history of foreign body inhalation . Recurrent chest infection with negative history foreign body inhalation needs bronchoscopy . Radiology should be done prior procedure .Bronchoscopy is procedure of choice for foreign body inhalation when a suspected, sometimes it's lifesaving.


Article
Resection and Reconstruction of Cervical Tracheal Stenosis

Authors: Adil Khamees Abdul-Hameed --- Waleed Mustafa Hussen --- Akeel Salman Yuser
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 3 Pages: 385-391
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :Tracheal resection and primary re anastomosis for tracheal stenosis or tracheal tumor is not uncommon operation .OBJECTIVE: To assess the aetiology of stenosis of cervical trachea and their surgical reconstruction .PATIENT AND METHODS:This is a retrospective study of forty patients with cervical tracheal stenosis ,who were treated at Ibn Al Nafees Hospital during six years period from January -2006 to October -2012 .It illustrates the diagnostic methods and the surgical techniques of reconstruction .RESULTS: Most of the patients ,were male (80%) and only (20%) were female .The most common etiological factor was post intubation stenosis (70%),less common cause was traumatic stenosis and the least was neoplastic stenosis . Progressive dyspnea was the most common presenting clinical feature .The mean length of resection was three rings .Seven patients developed complications , and dealt with successfully with one mortality .CONCLUSION: Bronchoscopy and radiography remain the main diagnostic tool for evaluating it .Resection and end to end anastamosis is the best method of treatment In special cases .Some cases can be treated by endoscopy and laser therapy .


Article
Head Scurf pin Aspiration, A sub type of Foreign Body Aspiration
أستنشاق دنبوس وشاح الرأس,نوع خاص من أستنشاق الأجسام الغريبة

Author: Ihssan Ali Hais Elamery أحسان علي هايس العامري
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2019 Volume: 16 Issue: 2 Pages: 101-106
Publisher: Diyala University جامعة ديالى

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Abstract

Background: Scurf pin inhalation is serious problem especially in muslim girls, who wear head cover and holding the pin by using her teeth or lips during wearing her scurf or laughing or coughing leading to accidental foreign body aspiration. Rigid Bronchoscopy is the treatment of choice and rarely surgery is needed.Objective:To study a presentation, management and prognosis of those patient.Patients and Methods: A retrospective study involving the patients with a history of pin aspiration conducted at the department of thoracic surgery , Imam Hussein medical city in kerbala for Dec. 2012 till Dec. 2017.Results: 262 patients are included. The pins were removed by using rigid bronchoscopy in 251 cases safely without any complications ,4patients were coughed the pin before enter the theatre room&7patients were coughed and swallowed it in digestive tract. Conclusion: Scurf pin aspiration is a common problem in Iraqi Muslim females who wear Hijab. It can be easily preventable by health education and/or newly fashioned scarves that do not need pins for fixation but use press studs or something else. The left main bronchus is the site were the pin is commonly impacted and Rigid bronchoscope is mostly used for pin removal.

خلفية الدراسة: ان استنشاق الدنبوس المعدني المستعمل في تثبيت الحجاب يشكل مشكلة كبيرة في النساء المسلمات بالعراق اللاتي يرتدين الحجاب ,ان هذه المشكلة يمكن تلافيها ببساطة عن طريق التوعية والتثقيف الصحي للنساء لترك عادة وضع الدنابيس في الفم بين الشفتين خلال عملية لبس الحجاب او استعمال الطرق الاخرى لتثبيت الحجاب او استعمال انواع جديدة من الحجاب لاتحتاج الى استعمال الدنابيس في تثبيتها.اهداف الدراسة: لدراسة العرض التقديمي وإدارة والتشخيص من هؤلاء المرضى.المرضى والطرائق: دراسة بأثر رجعي شملت المرضى الذين لديهم تاريخ من استنشاق دبوس أجريت في قسم الجراحة الصدرية ، مدينة الإمام حسين الطبية في كربلاء منذ ديسمبر 2012 حتى ديسمبر 2017.النتائج: يتضمين 262 مريضا تمت إزالة المسامير باستخدام تنظير القصبات الصلب في 251 حالة بأمان دون أي مضاعفات ، تم سعال 4 مرضى الدبوس قبل الدخول إلى غرفة المسرح وتم سعال 7 مرضى وابتلاعها في الجهاز الهضمي.الاستنتاجات : بالرغم من كون استنساق الدنابيس المستعملة في تثبيت الحجاب يشكل مشكلة صحية كبيرة مع مضاعفات قد تكون خطيرة الا ان تشخيصها سهل نسبياً و ذلك بسؤال المريضة عن كيفية استنشاق الدنبوس مع اخذ الرقوق الشعاية للصدر حيث ان الدنبوس هو جسم معدني يسهل ايجادة في الرقوق الشعاعية .ان ناظور القصبات يبقى الحل الامثل والانسب لاستخراج دنابيس تثبيت الحجاب وخصوصاً النوع الصلب منه حيث انه يمنع تخدش وجرح بطانة القصبات الهوائية اثناء استخراج الدنابيس.


Article
Inhalational Anaesthesia Versus Total Intravenous Anaesthesia During a Rigid Bronchoscopy in Paediatrics

Author: Osama Haider Al-Hassani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2014 Volume: 13 Issue: 4 Pages: 504-508
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND :General anaesthesia is routinely used for rigid bronchoscopy in paediatrics for different causes. Both methods of anaesthesia were used inhalational and total intravenous anaesthesia (TIVA).OBJECTIVE:Is to compare inhalational anaesthesia with total intravenous anaesthesia (TIVA) for rigid bronchoscopy in paediatric age group in regard to the heart rate, oxygen saturation, coughing, bucking, laryngeal spasm and bronchospasm.PATIENT AND METHOD:Thirty patients aged 2-6 years were chosen, divided randomly in two groups. In group I ( inhalational anaesthesia) consisted of 15 patients and the anaesthesia was maintained with halothane while in group II use (total intravenous anaesthesia) TIVA was consist of 15 patients and anaesthesia was inducd and maintained with remifentanyl and propofol. The heart rate, oxygen saturation, coughing, laryngeal spasm and bronchospasm were evaluated during and after the procedure.RESULT:Blood oxygenation and Heart rate were more stable in group II (P=0.045 and P=0.024 respectively). There were slightly less cough and bucking in group II as compare with group I.CONCLUSION:TIVA is a good choice of anaesthesia during rigid bronchoscopy because of a good and stable level of blood oxygenation and heart rate. Coughing, bucking, laryngeal spasm and bronchospasm were less in TIVA group compare with inhalational group.

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