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Long term follow up after inhalation of foreign bodies
H Davies1, I Gordon, D J Matthew
1Hospital for Sick Children, London.
Insights
Foreign body aspiration in children can lead to long-term complications. Left lung impaction with initial radiographic collapse indicates a higher risk, necessitating close follow-up for pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Medical Imaging
- Thoracic Surgery
Background:
- Inhalation of foreign bodies is a common pediatric emergency.
- Long-term sequelae of foreign body aspiration require thorough investigation.
Purpose of the Study:
- To review the long-term results of foreign body aspiration treatment in children.
- To identify prognostic factors for long-term complications.
Main Methods:
- Retrospective review of pediatric patients treated for foreign body aspiration.
- Clinical assessment, chest radiography, and ventilation/perfusion (V/Q) lung scans were utilized.
- Analysis of impaction site, initial radiographic appearance, and time to removal.
Main Results:
- Abnormal chest radiographs and V/Q lung scans were observed in a significant proportion of reviewed children.
- Left lung impaction combined with initial radiographic collapse/consolidation was associated with the highest risk.
- Incidence in the district hospital population was approximately 1 in 14,000 per year.
Conclusions:
- Foreign body aspiration can result in persistent respiratory issues.
- Specific clinical and imaging findings predict a poorer long-term prognosis.
- Children with high-risk factors require vigilant follow-up care.
Abstract:
The long term results of treatment of inhalation of foreign bodies in a district children's hospital and in a tertiary referral centre were reviewed by clinical assessment, chest radiography, and standard four view 81mKr ventilation/99mTc macroaggregated albumin perfusion imaging (V/Q lung scan). The overall incidence in the population served by the district hospital was roughly one in 14,000/year. Of the 12 children reviewed there, three had abnormal chest radiographs and four had abnormal V/Q scans as a result of inhalation of the foreign bodies. Of 21 children treated and reviewed at the referral centre, eight had abnormal chest radiographs, and 14 had abnormal V/Q lung scans. Three factors were assessed for prognostic importance: site of impaction, initial radiographic appearance, and time before removal. A child who had inhaled a foreign body into the left lung and who had collapse/consolidation on the initial chest radiograph was at greatest risk of long term complications. These children merit close follow up.