Bronchial foreign body vs asthma

Area of Science:

• Pediatric Pulmonology
• Medical Diagnostics
• Foreign Body Aspiration

Background:

• Foreign bodies in the respiratory tract are often unsuspected in children.
• Symptoms like reactive airways disease (RAD) or croup syndrome can mask foreign body aspiration.
• A significant number of pediatric respiratory cases lack clear roentgenologic findings.

Purpose of the Study:

• To investigate the efficacy of a test-therapy approach for diagnosing and managing unsuspected foreign bodies in children.
• To evaluate the response to medical treatment in children with respiratory symptoms and suspected foreign bodies.

Main Methods:

• Retrospective analysis of 30 children with foreign bodies extracted from the respiratory tract (January 1983 - June 1988).
• Focus on 12 children with no initial roentgenologic findings, presenting with RAD or croup syndrome.
• Administration of a test-therapy including theophylline, corticosteroids, and epinephrine.

Main Results:

• Two patients with subglottic foreign bodies (SFB) showed no response to the test-therapy.
• Seven out of ten patients with bronchial foreign bodies (BFB) experienced decreased or resolved wheezing in the unaffected lung.
• No improvement in wheezing was noted in the lung directly affected by a foreign body in the main bronchus.

Conclusions:

• Medical test-therapy can offer diagnostic clues for unsuspected foreign bodies in pediatric respiratory cases.
• Theophylline, corticosteroids, and epinephrine may partially alleviate symptoms in some cases of bronchial foreign bodies.
• Subglottic foreign bodies are unlikely to respond to this specific medical intervention.