[Tracheobronchial foreign bodies. Diagnostic and therapeutic aspects in children]

In this retrospective study, the authors reviewed 31 cases of tracheobronchial foreign body in children ranging in age from one to 15 years, recruited in Ariana hospital since 1987. 74% of the patients were male, and only 26% were less than 3 years old. The foreign body is mostly revealed by a radio-clinical presentation of a feverish bronchopneumonia (32%); children were referred to the hospital within 15.4 months. Although penetration syndrome was reported in 61% of patients, it represented the reason of consultation in only 19% of cases, and children were referred within 4.5 days. The main radiographic findings were atelectasis (32%) and non specific foci of pneumonia (19%). Air trapping was noted in just 10% of cases. 55% of foreign bodies were vegetable in nature, with sunflower seeds at the head of the list (16%). They have been lodged preferentially in the right bronchial tree (58%) and 51% of them were found in the mainstem bronchus. 71% were removed by endoscopic procedures; a surgical operation was performed in 6 cases (19%): one case of pneumotomy to extract a metallic foreign body from distal respiratory tract, and five cases of parenchymal excision, including four for bronchiectasis. 77% of patients had symptoms that lasted at least 2 weeks before diagnosis; the long delay in diagnosis (average of 7.6 months) explains the high-level of bronchiectasis in our study (22%). The authors emphasize the necessity to promote preventive measures by information parents and physicians on risks of foreign body aspiration, which early diagnosis can save much trouble in children.