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Foreign body aspiration in children.

Fabio Midulla1, Roberto Guidi, Angelo Barbato

  • 1Department of Pediatric Emergency, University La Sapienza of Rome, Rome, Italy. midulla@uniroma1.it

Pediatrics International : Official Journal of the Japan Pediatric Society
|December 16, 2005
PubMed
Summary

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Clinical symptoms and radiological findings have low diagnostic value for diagnosing foreign body aspiration (FBA) in children. Pre-bronchoscopy evaluations are often insufficient for confirming FBA, necessitating further diagnostic steps.

Area of Science:

  • Pediatric Pulmonology
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Foreign body aspiration (FBA) is a common pediatric emergency.
  • Accurate diagnosis of FBA is crucial for timely intervention.
  • Pre-bronchoscopy clinical and radiological findings are often used to guide diagnosis.

Purpose of the Study:

  • To evaluate the diagnostic utility of physical and radiological findings preceding bronchoscopy in suspected pediatric foreign body aspiration.
  • To determine the sensitivity and specificity of clinical signs and imaging in diagnosing FBA.

Main Methods:

  • Retrospective review of clinical records for 82 pediatric patients with suspected foreign body aspiration.
  • Analysis of physical examination findings and chest X-ray results.

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  • Correlation of findings with confirmed foreign body retrieval via bronchoscopy.

    • Main Results:

    • Foreign body aspiration was confirmed in 70 children (85.4%), predominantly those under 3 years old.
    • Common symptoms included persistent cough (75%) and decreased breath sounds (62.8%).
    • Radiological findings like air trapping (43.6%) and atelectasis (40%) were frequent, but chest X-rays were normal in 20% of cases.

    Conclusions:

    • Clinical symptoms and radiological findings alone possess limited diagnostic value for foreign body aspiration in children.
    • The sensitivity of clinical findings was poor, despite a high positive predictive value.
    • Radiological findings showed moderate sensitivity (80%) but low specificity (33%) for diagnosing FBA.