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Tracheobronchial foreign body aspiration in children: A continuing diagnostic challenge
1Department of Pediatric Surgery, Children Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
Insights
Foreign body aspiration (FBA) in children often presents with cough and choking. Delayed diagnosis, frequently due to physician misdiagnosis, leads to complications, highlighting the need for prompt identification and removal of aspirated foreign bodies.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Foreign body aspiration (FBA) is a significant cause of pediatric respiratory distress.
- Timely diagnosis and intervention are crucial for favorable outcomes in pediatric FBA cases.
Purpose of the Study:
- To analyze the clinical features and outcomes of children with foreign body aspiration (FBA).
- To identify factors contributing to delayed diagnosis in pediatric FBA cases.
- To evaluate the impact of diagnostic delays on patient outcomes.
Main Methods:
- Retrospective review of 158 children with suspected foreign body aspiration (FBA) from July 2001 to June 2010.
- Data collected included patient demographics, clinical presentation, radiographic findings, bronchoscopic results, and reasons for diagnostic delay.
- Comparison of outcomes between early (<14 days) and late (>14 days) presentations.
Main Results:
- Persistent cough and choking were the most common symptoms of FBA.
- Air trapping (40%) and atelectasis (14%) were frequent radiographic findings, though 32.2% of radiographs were normal.
- Delayed diagnosis, primarily due to physician misdiagnosis (41.6%), was associated with a higher incidence of complications (29 vs. 10 children).
- Watermelon seeds and peanuts constituted 80% of aspirated foreign bodies.
Conclusions:
- Foreign body aspiration (FBA) in children presents diagnostic challenges.
- Delays in FBA diagnosis are often linked to insufficient consideration of the condition by healthcare providers.
- Emphasizing early diagnosis and foreign body removal is essential to prevent serious complications in pediatric patients.
Background:
Foreign body aspiration (FBA) is a common cause of respiratory compromise in early childhood. The objective of this study was to describe the features and outcomes of children with FBA in early and late presentations and to examine the reasons for the delay in diagnosis.
Patients And Methods:
This is a retrospective review of all children who were admitted with suspected FBA between July 2001 and June 2010. Patient's characteristics, history, clinical, radiographic, bronchoscopic findings, reason for delay presentation, and complications were noted.
Results:
A total of 158 children admitted to the hospital with suspected FBA were included in this study. The average age was 3.28 years. Forty-eight (30.3%) children were presented late (more than 14 days after FBA) and 110 (69.7%) children were presented early (0-14 days). The common clinical manifestations of FBA were persistent cough (100%) and choking (72%). The most frequent radiological finding observed was air trapping (40%) followed by atelectasis (14%). Chest radiographs were normal in 32.2% patients. Ten children in early diagnosis group and 29 children in late diagnosis group presented with complications. The diagnosis delay was mainly attributed to physician misdiagnosis (41.6%). Rigid bronchoscopy was performed in all patients. Foreign body was found in all of the cases except six. Watermelon seeds and peanuts accounted for 80% of the aspiration.
Conclusion:
FBA is difficult to diagnose in children. Delay in diagnosis appears to result from a failure to give serious consideration to the diagnosis. Early diagnosis and removal of foreign bodies must be achieved to avoid complications.
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