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Published on: January 17, 2011
[Foreign body aspiration in childhood. Review of 210 cases]
I Fernández Jiménez1, C Gutiérrez Segura, V Alvarez Muñoz
1Servicio de Cirugía Pediátrica, Hospital Central de Asturias, Oviedo. ferjinmi@yahoo.es
Insights
Foreign body aspiration in children is common. A detailed patient history is crucial for diagnosis, alongside physical examination, while chest X-rays are less reliable.
Area of Science:
- Pediatric emergency medicine
- Respiratory diseases
- Accident prevention
Context:
- Foreign body aspiration is a frequent cause of childhood morbidity and mortality.
- Children's curiosity and underdeveloped swallowing mechanisms increase aspiration risk.
- Timely diagnosis is critical for effective management and improved outcomes.
Purpose:
- To identify common signs and symptoms of foreign body aspiration in children.
- To evaluate the diagnostic utility of detailed patient history (anamnesis).
- To assess the effectiveness of physical examination, respiratory auscultation, and chest X-rays in diagnosis.
Summary:
- A retrospective study analyzed 210 pediatric foreign body aspiration cases.
- Rigid bronchoscopy confirmed foreign bodies in 90% of patients.
- Vegetable fragments were the most common aspirated objects (82%).
Impact:
- Thorough patient history demonstrated high sensitivity (80%) for diagnosing choking crises and persistent cough.
- Physical examination and auscultation showed high sensitivity (90%) but low specificity (16%).
- Chest X-rays exhibited low sensitivity (16% false negatives), highlighting limitations in diagnosing foreign body aspiration.
Aim:
Foreign body aspiration is one of the accidents with highest incidence, morbidity and mortality in childhood. It is favoured by curiosity and the immature swallowing mechanisms of this age group. To determine the most common signs and symptoms leading to the diagnosis of foreign body aspiration and to demonstrate the diagnostic value of a detailed anamnesis, we analyzed the cases of foreign body aspiration treated in our hospital between 1975 and 1997.
Materials And Methods:
Retrospective study of 210 patients with suspected foreign body aspiration. In 208 patients rigid bronchoscopy was performed. Evidence of a foreign body was found in 90%.
Results And Conclusions:
We emphasize the clinical value of thorough anamnesis which showed high sensitivity (80%) in choking crises and persistent cough. Physical examination and respiratory auscultation showed high sensitivity (90%) but low specificity (16%). Chest X-ray showed the lowest sensitivity with 16% of false negatives. Most foreign bodies were vegetable fragments (82%), with a complication rate of 5.7%. Mortality was 0.9%, with no deaths occurring in the last 8 years.
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