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Published on: September 11, 2018
Clinico-radiological parameters predicting early diagnosis of foreign body aspiration in children
Pradipta Kumar Parida1, Nirmal Shanmugasundaram, Surianarayanan Gopalakrishnan
1Department of Otolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, 605006 Pondicherry, India. drpradipta04@gmail.com.
Insights
Early diagnosis of foreign body (FB) aspiration in children can be achieved by identifying key clinical signs like penetration syndrome and radiological findings such as unilateral hyperinflation. These indicators aid in prompt identification and management of pediatric FB aspiration.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Foreign body (FB) aspiration is a common cause of respiratory distress in children.
- Timely diagnosis is crucial for preventing complications such as pneumonia and airway obstruction.
Purpose of the Study:
- To investigate clinical and radiological findings for the early diagnosis of foreign body aspiration in pediatric patients.
- To identify key indicators that can assist clinicians in prompt diagnosis.
Main Methods:
- A prospective study involving 45 children under 12 years old with suspected FB aspiration.
- Rigid bronchoscopy was performed, and data from 37 children with confirmed FB aspiration were analyzed.
Main Results:
- The most frequent clinical features included penetration syndrome (89.2%) and decreased breath sounds (86.5%).
- Radiological findings commonly observed were unilateral hyperinflation (64.9%) and mediastinal shift (45.9%).
- Peanut (54.1%) was the most common food-related FB, with lodgement predominantly in the left main bronchus (37.8%).
Conclusions:
- Penetration syndrome and localized decreased breath sounds are significant clinical predictors.
- Unilateral hyperinflation and/or mediastinal shift on radiology are crucial for early diagnosis of FB aspiration in children.
Objectives:
This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children.
Patients And Methods:
This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children (22 males, 15 females; mean age 2.6 years; range 1 to 12 years) with positive for FB on bronchoscopy were analyzed.
Results:
Penetration syndrome (sudden onset coughing, choking and gagging) (89.2%) and decreased breath sounds (86.5%) were the most common clinical features. Cough, respiratory difficulty and fever were present in 83.8%, 78.4% and 27% respectively. Tachypnea, tachycardia, chest retractions, decreased chest movements and wheeze were present in 83.3%, 83.3%, 83.3%, 51.4% and 43.2% respectively. Unilateral hyperinflation (64.9%), mediastinal shift (45.9%), and collapse (21.6%) were common radiological signs on chest radiography and in 13.5% patients the chest X-rays were normal. Sites of FB lodgements were larynx, trachea, right main bronchus, left main bronchus and bilateral bronchi in 10.8%, 10.8%, 35.1%, 37.8 and 5.5% respectively. Food related FBs were present in 30 cases (peanut 54.1%) and inorganic FBs were present in seven cases.
Conclusion:
Penetration syndrome, localized decreased breath sounds, unilateral hyperinflation and/or mediastinal shift on radiology are predictors for early diagnosis of FB aspiration.
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