Rigid Bronchoscopy Indications, Complications and Outcome in Khartoum ENT Hospital

Abstract

Introduction: Rigid bronchoscopy is a technique that visualizes the trachea and proximal bronchi. It is usually performed in the operating room under general anesthesia. Rigid bronchoscopy is most commonly used to diagnose and manage patients who have obstruction of either their trachea or a proximal bronchus due to any reason. Patients and methods: This a prospective study conducted at Khartoum ENT hospital during the period April 2010 to April 2012. Every patient underwent rigid bronchoscopy, presented to Khartoum ENT hospital or referred from other parts of Sudan and the data collected by questionnaire. There were no exclusion criteria. Results: A total number of 103 patients are enrolled in the study. Forty seven percent were less than 2.5 years, with males predominance (53.4%). Fifty six percent reside outside Khartoum state. Thirty four percent of the patients presented after the first week of symptoms. All the studied patients were symptomatic; the most presenting symptom was cough which was recorded in 94.2%. On examination the findings mainly were crepitation (61.2%) then wheeze (59.2%) while the chest was normal in 8.7%. Plain chest X- ray was normal in 62.1 % and foreign body was visualized radiologically in 14.6%. Rigid bronchoscopy was indicated for foreign body removal in 74.8% and was diagnostic in 25.2%. The types of foreign bodies lodged mainly were organics in 63 out of 87 cases; the peanuts were in 36 cases then watermelon seeds in 13 Please purchase PDFcamp Printer on http://www.verypdf.com/ to remove this watermark. IV cases. Diagnostic bronchoscopy findings were; foreign bodies in 10 out of 26 cases and no foreign body were found in 7 cases, 6.8% of patients required tracheostomy during the procedure. The foreign bodies impacted in the right main bronchus were in 44 out of 87 cases (50.6%). In 88.3% of the patients one session of bronchoscopy was adequate for foreign body removal. Thirty four percent of the procedures were done after the 1st week of foreign body inhalation. Eighty two percent of the bronchoscopies lasted for less than 30 minutes. During the procedure the SPO2 was reached between 20%-0% in 18.4% of cases. In 90.3% of rigid bronchoscopies there was no complication, while the mortality rate was 3.9%. Reviews of data revealed that majority of the rigid bronchoscopies were performed for patients younger than 2.5 years mainly due to foreign body inhalation. Most of the findings of diagnostic bronchosopies were foreign bodies and most of the procedures passed uneventfully. Complications were occurred in 9.7%. Conclusion: Rigid bronchpscopy in Khartoum ENT hospital is mainly used for foreign body removal. Patients are mainly younger than 2.5 years. Mortality and morbidity are low due to well trained and supervised medical staff. Recommendations: Health education is a very important factor to prevent inhalation of foreign bodies among little kids. Early diagnoses and management of foreign body inhalation reduces the complications of foreign body and bronchoscopy. Availability of diagnostic and therapeutic procedures of foreign body inhalation outside Khartoum state will reduce the mortality and morbidity of this condition.