Foreign body aspirations in Infancy: a 20-year experience

Abstract

Objective: Foreign body aspirations comprise the majority of accidental deaths in childhood. Diagnostic delay may cause an increase in mortality and morbidity in cases without acute respiratory failure. We report our diagnostic and compare the relevant studies available in literature to our results.Methods: In our Hospital, bronchoscopy was performed on 1015 patients with the diagnosis of foreign body aspirations (from 1998 to 2008). Of these cases, 63.5% were male and 36.5% female. Their ages ranged from 2 months to 9 years (mean 2.3 years). Diagnosis was made on history, physical examination, radiological methods and bronchoscopy.Results: Foreign bodies were localized in the right main bronchus in 560 (55.1%) patients followed by left main bronchus in 191 (18.8%), trachea in 173 (17.1%), vocal cord in 75(7.4%) and both bronchus in 16 (1.6%). Foreign body was not found during bronchoscopy in 48 cases (8.7%). The majority of the foreign bodies were seeds. Foreign bodies were removed with bronchoscopy in all cases. Pneumonia occurs in only 2.9% (29/1015) patients out of our cases.Conclusion: Rigid bronchoscopy is very effective procedure for inhaled foreign body removal with fewer complications. Proper use of diagnostic techniques provides a high degree of success, and the treatment modality to be used depending on the type of the foreign body is mostly satisfactory.

25-Year Review of the Abundance and Diversity of Radiopaque Airway Foreign Bodies in Children

“…In a 15-year study by Chung-Hua, in China, chicken bones (12 cases) and fish bones (9 cases) (21 cases overall, 48.8 %) were the most common radiopaque FBs [20], which is consistent with our study. In a study by Nikakhlagh et al, the most common radiopaque objects were either meat and chicken bones (54 cases, 5.3 %) or metal (44 cases, 4.4 %) [12], while in Boufersaoui's 2013 study of 2,624 patients in Algeria, metal objects (272 cases, 10.36 %) (Hairpins alone counted for 169 cases, along with nails, screws, etc.) Were most common [21].…”

“…Meat, chicken and big fish Bones objects were [10]. Previous reports suggest that children in the first and second years of life are mainly exposed to FBs (63.5 %) [2,12,13]. Delayed diagnosis causes various complications, depending upon the location of the FB [14].…”

Demora en el diagnóstico de un cuerpo extraño en la vía aérea en los niños. Serie de casos

“…[1][2][3][4][5][6][7] Una historia positiva de ahogamiento o tos con dificultad respiratoria en un niño antes sano, que se encontraba jugando o comiendo, nunca debe ignorarse. El examen físico y radiológico puede ser engañosamente negativo después que el episodio crítico ha pasado, por lo que es necesario un alto índice de sospecha para el diagnóstico.…”

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“…The most common foreign bodies in children are coins, but marbles, button, batteries, safety pin and bottle tops have also been reported. While in adults, the most common foreign supervision contributes to this hazard in this age group [4]. Adults may swallow non-food objects accidentally or deliberately, when an underlying mental illness or a suicidal cause should be ruled out.…”