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Master Thesis

Corps étrangers des voies aériennes inférieures : présentations cliniques et conséquences face à un syndrome de pénétration

Abstract : Inhalation of foreign bodies is the second cause of accidental death amongst those under 6 years of age. Clinical presentation can vary a lot and can be summarized in one sudden cough access, making bronchic fibroscopy essential. A recent prospective study suggests not performing an endoscopy when patients have no clinical and radiological signs. The main objective of this retrospective single centre study, conducted in Bordeaux between 2008 and 2013, was to check the relevance of this approach to our population. The secondary objectives were : to describe the population, to assess the performance parameters and to study the correlation between the data and the actual presence of a foreign body. Of the 142 patients, the majority of which were boys, the mean age was 37.8 months and the median age was 21 months. Clinical history found most often the presence of a witness, coughing or asphyxiation. The majority of clinical and radio! logical abnormalities seen were persistent coughing, stridor, auscultatory asymmetry, dyspnea and trapping. Physical examination was normal in 34.5% of cases and chest radiography in 52.2%. Endoscopy was positive for 38.1%. Among these patients, 21.2% had only physical signs, 1.9% had only radiological signs and 75% had both. Of the 36 cases that showed no signs, 1 patient had a foreign body. In univariate analysis, there is no anamnestic evidence to discriminate between patients with and without a foreign body. Sensitivities and negative predictive values of the presence of clinical and radiological signs are 96% and 75%, and 96% and 81% respectively. The absence of any sign has a negative predictive value of 97%. The decision tree tested on our population isn't valid, given the potential severity.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01164719
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, June 17, 2015 - 3:52:59 PM
Last modification on : Wednesday, August 23, 2017 - 4:32:02 PM
Long-term archiving on: : Tuesday, April 25, 2017 - 11:11:30 AM

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Céline Charasse. Corps étrangers des voies aériennes inférieures : présentations cliniques et conséquences face à un syndrome de pénétration. Médecine humaine et pathologie. 2015. ⟨dumas-01164719⟩

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