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Pneumomediastinum caused by foreign body aspiration in children
E M Burton1, W Riggs, R A Kaufman
1Department of Radiology, LeBonheur Children's Medical Center, Memphis, Tennessee.
Insights
Pneumomediastinum (PM) in young children without trauma may indicate foreign body aspiration (FBA). This finding on initial chest X-rays warrants further investigation for FBA in this population.
Area of Science:
- Pediatric Pulmonology
- Pediatric Radiology
- Emergency Medicine
Background:
- Foreign body aspiration (FBA) is a common pediatric emergency.
- Pneumomediastinum (PM) is a rare but serious complication of FBA.
- Early diagnosis of FBA is crucial for effective management.
Purpose of the Study:
- To evaluate the association between pneumomediastinum and tracheobronchial foreign body aspiration in children.
- To determine the diagnostic value of pneumomediastinum in identifying FBA in young children.
Main Methods:
- Retrospective review of 155 children with tracheobronchial foreign body aspiration.
- Analysis of initial chest radiographs for the presence of pneumomediastinum.
- Correlation of pneumomediastinum findings with clinical presentation and bronchoscopy results.
Main Results:
- Ten out of 155 patients (6.5%) presented with pneumomediastinum on initial chest radiograph.
- Nine of these ten patients had pneumomediastinum at presentation; one developed it post-bronchoscopy.
- Pneumomediastinum was observed in children with FBA, suggesting a potential link.
Conclusions:
- Pneumomediastinum on initial chest radiography in children under two years old, without a history of trauma, should raise suspicion for foreign body aspiration.
- Radiographic detection of pneumomediastinum can serve as an important clue for further investigation of FBA in this vulnerable age group.
Abstract:
In a retrospective review of 155 children with tracheobronchial foreign body aspiration (FBA), there were ten patients who had pneumomediastinum (PM) on an initial chest radiograph. Nine of ten presented with PM and one patient had PM noted after bronchoscopy. In a child less than two years of age with no history of trauma, the radiographic finding of PM should prompt further investigation for FBA.