Foreign Body Aspiration in Children – A Case Report

Foreign body aspiration (FBA) is an important cause of morbidity and mortality in pediatrics. Most cases occur in children younger than 3 years, and the classic triad of choking, cough, and unilateral wheezing or decreased air entry is seen in only a minority of patients.Food and food-related items are by far the most commonly aspirated across all age groups. Older children tend to aspirate nonfood materials such as pen caps and pins more frequently than do younger children. Oftentimes, the diagnosis can be challenging when an aspiration event is not directly witnessed. Management depends on the acuity of the presentation. Patients with evidence of complete upper airway obstruction should have age-appropriate basic life support maneuvers performed. Patients with partial obstruction who are able to maintain their airway but with potential for deterioration should be taken immediately to the operating room for removal whenever possible. Stable patients may have radiographic studies performed to assist in risk stratification. Patients in whom suspicion for FBA is high should undergo bronchoscopy, whereas a subset of low-risk patients may be observed. Delays in diagnosis increase the risk of complications.We present a 6-years old boy who was sent to our center with diagnosis of a foreign body in right main bronchus and carina with stable vital signs, after a period of chocking and cough. CXR and thoracic CT scan had been performed at the previous medical center. CXR was not diagnostic but tomography showed a long tubular foreign body in the right main bronchus and carina. The child was planned for rigid bronchoscopy under general anesthesia. With the help of forceps the foreign body was removed, which was 4.5 cm length part of pen barrel. The immediate postoperative period was uneventful and the child was discharged on postoperative day.