Foreign Body Aspiration in Children

Introduction:Foreign body aspiration (FBA) in children is a common and potentially dangerous situation that delays in diagnosis and treatment can be associated to significant morbidity and an emergency bronchoscopy must be performed in suspicious cases. Prevention is the most critical element needed to reduce this morbidity. The aim to this study is evaluate the history, symptoms, radiographic and endoscopic findings in these patients in order to develop precautionary measures oriented to this population.Methods:A retrospective, descriptive study analyzing data on 200 children under 14 years of age undergoing bronchoscopy due to clinical suspicion of FBA at the Al Zahra and Kashani hospitals in Isfahan during 10 years.Result:Fifty eight percent of patients were males. Most of admissions were in summer and autumn. Ninety percent of patients were under 5 years old and (62.5%) of them were under 2 years old. The most common presenting symptoms were sudden cough (78%), history of aspiration (74.5%) and cyanosis (63%). The most clinical findings were hoarseness (51%) and wheezing (35%). In most cases, CXR was normal but air trapping was the most common (15.5%) abnormal radiological finding. Watermelon nut was the most common aspirated body (31%). The most common location of foreign body trapping was in right bronchus (47%). In most cases the time of arrival to hospital was less than 24 hours (27.5%) and bronchoscopy was done in the admission day in (59%) of cases. In all patients rigid bronchoscopy was performed. Ninety-nine percent of patients had general anesthesia. Anesthesia time was 20-30 minutes in (80%) of cases. 166 patients had positive bronchoscopy. Among these patients, obvious foreign body was seen in 141 patients and in others, abnormal secretions were noted. The most common complication of procedure was laryngeal edema (22%).Conclusion:A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. In order to prevent FBA and make a timely diagnosis, continuous and extensive educational programs should be provided. Physician and especially parental education are the main guarantors of significantly reducedmorbidity and mortality in this pathology.