Problems with retrieval of long-standing inhaled foreign bodies in children

In the last 7 yrs, we have removed 51 foreign bodies inhaled by children. In five cases involving long-standing foreign bodies, retrieval of the inhaled objects was complicated by their peripheral location in the bronchial tree and by the presence of abundant granulation tissue. In two of these children, the inhaled foreign bodies had been pushed further down the bronchial tree during a previous unsuccessful bronchoscopy. The use of a rigid bronchoscope with optical peanut forceps and 2-4 doses of an aqueous solution of epinephrine 1:100,000, at the dosage of 0.1 mL.kg-1.body weight (during removal of granulation tissue and after removal of the foreign bodies) permitted the complete removal of the foreign bodies in one session and a good control of bleeding.