Tracheobronchial foreign bodies in adults

Article Abstract:

Aspiration or inhalation of foreign objects into the windpipe, or trachea, and lower air passages, or bronchi, rarely occurs in adults. The predisposing conditions to tracheobronchial aspiration, the effectiveness of removing foreign objects (foreign bodies) with a flexible fiberoptic or rigid bronchoscope, outcomes, and complications were assessed in 60 adult patients. All of the patients were evaluated with a bronchoscope, a tube with an optical system for viewing inside the trachea and bronchi. Foreign bodies were identified in 59 patients. Food particles had been aspirated into the tracheobronchial tree of 24 patients, dental and medical appliances in 19, and miscellaneous items such as pins, a tooth, a button, and a vitamin, in the remaining patients. Twenty-five of the 60 patients had impairment of protective airway mechanisms due to conditions such as neurologic disorders, loss of consciousness due to trauma, and the use of sedatives or alcohol. Bronchoscopy was successful in removing the foreign objects from the tracheobronchial tree of 57 patients. Flexible fiberoptic bronchoscopy was effective in 14 of 23 patients, and rigid bronchoscopy was successful in 43 of 44 patients, including 6 of 7 patients in whom flexible bronchoscopy failed. Surgery was necessary to remove the foreign body in three patients. Complications stemming from bronchoscopy did not occur often and were not serious. However, prolonged blockage of lung tissue by the foreign body caused chronic complications in four patients; bronchiectasis, or chronic dilation of the bronchi, affected three patients and narrowing of the airway occurred in one patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Usage, Bronchoscopy, Thoracotomy, Aspiration and aspirators, Aspiration (Physiology)

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Barrett esophagus: a sequela of chemotherapy

Article Abstract:

Barrett esophagus is a condition in which the epithelium (the outer cell layer) of the esophagus changes from a squamous, or flat, cell type to a columnar, or column-like, cell type. These abnormal tissue changes were initially thought to be caused by a birth-related defect, but are now believed to result from gastroesophageal reflux, the backflow of stomach contents onto the esophagus. A recent study showed that Barrett esophagus may also develop after chemotherapy. Two conditions that appear to contribute to the development of Barrett esophagus include destruction of the squamous epithelium and the presence of abnormal conditions during epithelial recovery. Three different types of epithelial cells develop in Barrett esophagus including specialized columnar epithelium, gastric fundic-type epithelium, and junctional-type epithelium. Barrett mucosa results from a process referred to as metaplasia, a microscopic tissue change in which one adult cell type replaces another adult cell type. The specialized columnar epithelium consists of cell types that are not normally found in the esophagus or stomach. The cells from which Barrett mucosa develops have not been identified, but may be the glandular, squamous epithelial, or stem cells of the esophagus. The mechanism whereby exposure to gastric secretions causes metaplasia of the esophagus is not known. It is unclear whether the risk of esophageal cancer is increased in patients with Barrett esophagus caused by chemotherapy. Hence, patients receiving curative chemotherapy over long periods should be periodically monitored for the development of esophageal cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Barrett's esophagus, Barrett esophagus, Chemotherapy, Combination, Combination chemotherapy, Iatrogenic diseases, editorial

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Bay leaf impaction in the esophagus and hypopharynx

Article Abstract:

Foreign bodies commonly become lodged in the gastrointestinal tract, and most pass through without producing any symptoms. But between 10 and 20 percent of these ingested objects fail to pass through the gut, and can cause gastrointestinal discomfort or even death. The management of such patients has been detailed in the literature, but little has been written about the effects of bay leaves that become lodged in the pharynx (back of the throat) or the esophagus (the muscular tube that conveys food from the pharynx to the stomach). Five cases are described in which the patients had just eaten food containing bay leaves. Endoscopy, a procedure that permits the visualization of the throat, esophagus and other gastrointestinal structures, showed that the esophagi of all the patients were normal, except for the lodged bay leaf. None of the patients had previously experienced pain while eating and all were isolated episodes. It is recommended that a bay leaf which becomes lodged in the back of the throat be retrieved. A bay leaf that becomes lodged in the esophagus can be either forced into the stomach or retrieved. A delay in treatment can cause the patient discomfort and may lead to serious complications. Since only one of the patients realized that his discomfort stemmed from ingestion of bay leaves, this problem is most likely underreported. Physicians should be aware of the dangers concerning the ingestion of bay leaves and other foreign bodies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Injuries, Esophagus, Endoscopy, Pharynx, Bay (Tree), Bay (Plant)

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