Download PDF
J Pediatr Intensive Care 2018; 07(03): 126-128
DOI: 10.1055/s-0037-1613672
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Pen Cap Aspirations: Maneuvering for Successful Extraction

Jai Kumar Mahajan
1   Postgraduate Institute of Medical Education and Research, Chandigarh, India
,
Suhith G. Rao
1   Postgraduate Institute of Medical Education and Research, Chandigarh, India
› Author Affiliations
Further Information

Publication History

11 July 2017

17 November 2017

Publication Date:
18 December 2017 (online)

    Permissions and Reprints

Abstract

Aim of this study was to analyze the therapeutic approach with enhanced success of bronchoscopy. We retrospectively analyzed the results of bronchoscopic extraction of pen cap aspirations in our unit from 2000 to 2014. Out of 239 bronchoscopies performed for foreign bodies in airways, there were 8 cases of pen cap aspirations. All 8 were males and age ranged from 5 to 11 years. Seven cases had definitive history, while one patient had a history of chronic respiratory ailment. The foreign bodies were lodged in right and left bronchi in four cases each and seven had their open-end toward the proximal airways. Bronchoscopic extraction was successful in seven patients. The maneuver of rotating the optical forceps by 90 degrees so as to align the pen cap with the vocal cords resulted in success in all the cases. One patient underwent thoracotomy and bronchotomy for removal. Pen cap aspirations occur in school-going children. Aligning the optical forceps with vocal cords during extraction avoids the need for tracheostomy or thoracotomy.

Keywords

foreign body - pen cap aspirations - bronchoscopy - tracheostomy - thoracotomy
 

  • References

  • 1 Foltran F, Ballali S, Rodriguez H. , et al. Inhaled foreign bodies in children: a global perspective on their epidemiological, clinical, and preventive aspects. Pediatr Pulmonol 2013; 48 (04) 344-351
    CrossrefPubMedGoogle Scholar
  • 2 Rodríguez H, Passali GC, Gregori D. , et al. Management of foreign bodies in the airway and oesophagus. Int J Pediatr Otorhinolaryngol 2012; 76 (Suppl. 01) S84-S91
    CrossrefPubMedGoogle Scholar
  • 3 Jiaqiang S, Jingwu S, Yanming H. , et al. Rigid bronchoscopy for inhaled pen caps in children. J Pediatr Surg 2009; 44 (09) 1708-1711
    CrossrefPubMedGoogle Scholar
  • 4 Sersar SI, Ismail MF, Elsoroghi HA, AbdelMooty H. The value of open surgical approaches for aspirated pen caps: revisited. J Pediatr Surg 2006; 41 (04) 875-876 , author reply 875–876
    PubMedGoogle Scholar
  • 5 Zhijun C, Fugao Z, Niankai Z, Jingjing C. Therapeutic experience from 1428 patients with pediatric tracheobronchial foreign body. J Pediatr Surg 2008; 43 (04) 718-721
    CrossrefPubMedGoogle Scholar
  • 6 Cataneo AJ, Cataneo DC, Ruiz Jr RL. Management of tracheobronchial foreign body in children. Pediatr Surg Int 2008; 24 (02) 151-156
    CrossrefPubMedGoogle Scholar
  • 7 Ulkü R, Onen A, Onat S, Ozçelik C. The value of open surgical approaches for aspirated pen caps. J Pediatr Surg 2005; 40 (11) 1780-1783
    CrossrefPubMedGoogle Scholar
  • 8 Emir H, Tekant G, Beşik C. , et al. Bronchoscopic removal of tracheobroncheal foreign bodies: value of patient history and timing. Pediatr Surg Int 2001; 17 (2–3): 85-87
    CrossrefPubMedGoogle Scholar
  • 9 Seifarth FG, Triana J, Knight CG. Aspiration of a perforated pen cap: complete tracheal obstruction without radiologic evidence. Ann Pediatr Surg 2012; 8: 22-24
    PubMedGoogle Scholar
  • 10 Mahajan JK, Rathod KK, Bawa M, Rao KL. Tracheobronchial foreign body aspirations: lessons learned from a 10-year audit. J Bronchology Interv Pulmonol 2011; 18 (03) 223-228
    CrossrefPubMedGoogle Scholar