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Foreign body aspiration in children
1Department of Surgical Endoscopy, Universitätsklinikum Mannheim, University of Heidelberg, Mannheim, Germany.
Insights
Early diagnosis and bronchoscopy are crucial for children with foreign body aspiration. Timely removal significantly improves outcomes and reduces complications associated with tracheobronchial foreign bodies.
Area of Science:
- Pediatric Pulmonology
- Pediatric Bronchoscopy
- Foreign Body Aspiration
Background:
- Controversy exists regarding optimal diagnostic procedures, endoscopic approaches, and complication rates for pediatric foreign body aspiration.
- Foreign body aspiration in children presents diagnostic and management challenges.
Purpose of the Study:
- To review data on children suspected of foreign body aspiration.
- To analyze diagnostic findings, clinical features, and outcomes of foreign body aspiration in children.
Main Methods:
- Retrospective review of 98 children suspected of foreign body aspiration (January 1990 - December 1998).
- Analysis of clinical presentation, radiographic findings, foreign body characteristics, and treatment outcomes.
Main Results:
- Foreign body aspiration identified in 70% of children, predominantly those under 2 years old.
- Common clinical signs included fever, pneumonia, and coughing; 84% had abnormal chest radiographs.
- Bronchoscopic extraction was successful in 93% of cases, with a low morbidity (0.96%) and zero mortality.
Conclusions:
- Outcomes and complications are strongly linked to the duration of foreign body retention in the tracheobronchial system.
- Emphasizes the critical importance of early bronchoscopy for suspected foreign body aspiration.
- Highlights the need for increased public and professional awareness regarding pediatric foreign body aspiration.
Background:
There is still considerable controversy about the diagnostic procedure, the endoscopic approach, and the complication rate with foreign body aspiration in children.
Methods:
Review of our data for 98 children suspected for foreign body aspiration between January 1990 and December 1998 was performed.
Results:
In this data review, 78% of the children studied were younger than 2 years. A foreign body aspiration was identified in 70%, and 67% had a definite history of aspiration. Predominant clinical features were fever (46%), pneumonia (39%), and coughing (29%). Pathologic chest radiographs were found in 84% of the children. Sixty-two percent of the foreign bodies were trapped in the right lung, and 87% were of organic in origin. In 93%, a single endoscopic procedure was successful in removing the foreign bodies. The mean time between aspiration and bronchoscopic extraction was 5.4 days (range, 1 h to 36 weeks). The procedure-related morbidity rate was 0.96% and the mortality 0.
Conclusions:
Outcome and complications were found to depend mainly on the time the foreign body stayed in the tracheobronchial system. Early bronchoscopy is paramount in any case of suspected foreign body aspiration, and it is mandatory to increase the awareness of the population and medical professionals.