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The relationship between time of admittance and complications in paediatric tracheobronchial foreign body aspiration
M Sirmali1, H Türüt, E Kisacik
1Department of Thoracic Surgery, Atatürk Training and Research Hospital for Chest Disease and Chest Surgery, Ankara, Turkey. mehmetsirmali@yahoo.com
Insights
Prompt medical attention within 24 hours for pediatric tracheobronchial foreign body aspiration to prevent complications. Early diagnosis and bronchoscopy are crucial for a favorable outcome and avoiding conditions like bronchiectasis.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Otolaryngology
Background:
- Tracheobronchial foreign body aspiration is a common and potentially life-threatening event in children.
- Timely medical intervention is crucial for managing pediatric foreign body aspirations.
Purpose of the Study:
- To investigate the relationship between the time of hospital admittance and the development of complications in children with tracheobronchial foreign body aspiration.
- To identify risk factors associated with adverse outcomes in pediatric tracheobronchial foreign body aspiration.
Main Methods:
- Retrospective review of pediatric patients (≤16 years) with tracheobronchial foreign body aspiration between 1990 and 2005.
- Analysis of patient demographics, symptoms, radiological findings, foreign body type, and time of admittance.
- Cases were grouped based on admittance times to assess complication rates.
Main Results:
- 263 children were included; common foreign bodies were organic (seeds, nuts).
- Radiology detected the foreign body in 80.3% of cases; 19.7% had normal imaging.
- No complications occurred in patients presenting within 24 hours; later presentations showed fever, purulent sputum, hemoptysis, and bronchiectasis.
Conclusions:
- Early medical attention (within 24 hours) for pediatric tracheobronchial foreign body aspiration is critical to prevent complications.
- Organic foreign bodies and prolonged retention (≥30 days) are significant risk factors for bronchiectasis.
- Early bronchoscopy is recommended for suspected cases to avoid serious complications like bronchiectasis.
Purpose:
Majority of tracheobronchial foreign body aspirations occur in paediatric age group and may constitute a life hazard. We examined the relationship between the time of admittance and complications in children with tracheobronchial foreign body aspiration.
Material And Methods:
Sex, age, time of admittance, presenting symptoms, radiological findings, and the nature of the foreign body were reviewed retrospectively in patients aged 16 and under follow-up for tracheobronchial foreign body aspiration between January 1990 and January 2005. Cases were randomly assigned into 6 groups based on admittance times.
Results:
Within 15-year period, 263 children under the age of 16 were followed-up for tracheobronchial aspiration of foreign body. The most commonly aspirated foreign bodies included sunflower seed, peanut, hazelnut, walnut. While the pathology could be detected radiographically in 80.3% (n : 211) of the cases, in 19.7% (n : 52) radiology was normal. All cases had rigid bronchoscopy under general anaesthesia. In 220 cases foreign body was detected and could successfully be removed in 209 cases. The remaining 11 cases required bronchotomy or pneumotomy to remove the foreign body. Among 679 cases operated for bronchiectasis during the same period, 22 cases (3.2%) had foreign body as the aetiology. No complications were observed when the patients presented to the hospital within the first 24 hours after the aspiration while fever, purulent sputum, haemoptysis and bronchiectasis were noted in those presented later. Most of the complications were medically treated.
Conclusion:
Paying medical attention within the first 24 hours after the aspiration of foreign bodies is critical in order to accomplish a complication-free course. Organic foreign bodies and retention period of 30 days and over, constitute major risk factors in the development of bronchiectasis. It is advisable to perform bronchoscopy in the early stages of all suspected cases to avoid serious complications such as bronchiectasis.
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