A Case of Bronchial Foreign Body in a Premature Neonate Removed by Non-bronchoscopic Method

ABSTRACT

We report a premature neonate who suffered from bronchial foreign body. The neonate was delivered at 34 weeks of gestational age, 1,850 g of birth weight, through Cesarean section. After birth the baby showed respiratory distress and received surfactant therapy on the first hospital day. After extubation on the 10th hospital day, the baby experienced 2 episodes of pneumonia in the right upper lung field. On the 27th day after birth, a chest X-ray revealed a feeding tube-shaped foreign body which was located from right main bronchus to trachea, about 4.5 cm long and 2.0 mm wide. The patient was too small to remove the foreign body by even the smallest-diametered fibroptic bronchoscopy. We rotated the baby to a nearly 90 degree head-down position and percussed on the back. After confirming the movement of foreign body in to the trachea, we intubated 3.0 Fr. endotracheal tube under fluoroscopic observation. We found that a tip of foreign body was inserted into the ET tube innerside. We sucked out the foreign body by mechanical suction with central-holed rubber suction tip. Forced expiration with cough reflex and intubation with mechanical suction allowed for the successful removal of the foreign body.