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Foreign bodies aspirated in children: role of bronchoscopy

D Divisi1, S Di Tommaso, M Garramone

  • 1Thoracic Surgery, G. Mazzini Hospital of Teramo, University of L'Aquila, Teramo, Italy. duilio@virgilio.it

The Thoracic and Cardiovascular Surgeon
|June 5, 2007
PubMed

Insights

Rigid bronchoscopy effectively removed tracheobronchial foreign bodies in 97.2% of pediatric patients. While fiber-optic bronchoscopy offered 100% diagnostic accuracy, its therapeutic role in foreign body removal was limited.

Area of Science:

  • Pediatric Pulmonology
  • Interventional Bronchoscopy
  • Foreign Body Aspiration

Background:

  • Foreign body aspiration is a common pediatric emergency.
  • Bronchoscopy is the gold standard for diagnosis and removal.
  • Evaluating the efficacy of different bronchoscopy types is crucial.

Purpose of the Study:

  • To assess the diagnostic and therapeutic utility of fiber-optic and rigid bronchoscopy.
  • To compare the outcomes of these procedures in pediatric foreign body inhalation cases.

Main Methods:

  • A retrospective study of 128 pediatric patients with suspected foreign body aspiration from 1986-2004.
  • Patients were categorized based on chest X-ray findings (negative, direct signs, indirect signs).
  • Diagnostic and therapeutic success rates for both fiber-optic and rigid bronchoscopy were analyzed.

Main Results:

  • Rigid bronchoscopy successfully removed foreign bodies in 105 patients (97.2% success rate).
  • Fiber-optic bronchoscopy aided in foreign body removal in 13 patients (10.7% success rate).
  • Three patients required thoracotomy with bronchotomy.

Conclusions:

  • Rigid bronchoscopy is the primary therapeutic tool for pediatric tracheobronchial foreign bodies.
  • Fiber-optic bronchoscopy excels in diagnosis but has limited therapeutic application in these cases.
  • The choice of bronchoscopy should be guided by the suspected foreign body and clinical presentation.
Abstract

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