Date:27/03/2006 URL: http://www.thehindu.com/2006/03/27/stories/2006032720910300.htm

Karnataka - Bangalore

Correct diagnosis has helped save many children's lives

Sahana Charan

The TB institute has successfully treated patients for swallowing foreign particles

HELP IS AVAILABLE: Shashidhar Buggi (right), Director of SDS Tuberculosis and Rajiv Gandhi Institute of Chest Diseases, examining patients and at left are various foreign particles removed from patients at the institute. — Photo: V. Sreeniva sa Murthy

Bangalore: Twelve-year-old Mansoor would never have thought that chewing on a pen while doing his homework would almost cost him his life.

The boy from Bangalore had incessant cough and breathlessness and his family took him to various hospitals but in vain. One doctor told him he had tuberculosis (TB) and he was put on anti-TB tablets.

Finally, after three months when he was brought to the SDS Tuberculosis and Rajiv Gandhi Institute of Chest Diseases, the doctors there rightly diagnosed that there was a pen cap lodged in his bronchus (air passage).

This is just one among the numerous cases that the institute gets in which patients have swallowed a foreign body. In most cases, patients have been wrongly diagnosed in other places as having TB or a respiratory tract ailment.

The chest diseases institute has received more than 30 such cases so far and all the patients have been successfully treated.

At the moment there are three children, including Mansoor, who are being treated at the hospital for ingesting some foreign body.

Another boy, Satish (8), from Kanakapura had a tamarind seed in his bronchi and his lungs had collapsed. An endoscopy was done and the foreign body removed with the help of forceps.

"In many of these cases, the foreign body gets lodged in the bronchi or in the oesophagus and the patient may have cough, have difficulty in breathing, chest pain and wheezing.

As the air passage is blocked, the affected lung collapses fully or partially or it may swell like a balloon.

This causes unresolved or recurrent pneumonia and if the condition persists without the foreign body being removed for a long time, it may lead to the death of the patient," Shashidhar Buggi, Director of the institute, told The Hindu.

These cases are difficult to diagnose, because in most of these cases the article swallowed by the patient is not visible in an X-ray.

He added that in these cases they do an endoscopy of the bronchi or oesophagus to see the inside of the affected part and the object is removed with the help of forceps without cutting the affected part.

Some of the articles that doctors have found inside the bronchus and oesophagus at the hospital, which have been kept on display, include pen caps, safety pins, coconut pieces, groundnut, hairpin and plastic tubes.

"Since we have been seeing many such cases, we are able to diagnose correctly if there is a foreign body.

"Whenever patients, especially children, present with symptoms such as cough, wheezing and breathlessness and the problem persists, it is advisable to suspect the presence of a foreign body in the bronchial tract," Dr. Buggi said.