Respiratory Morbidity Following Foreign Body Aspiration Among South Indian Children: A Descriptive Study

Aim Our work aimed to study the clinical features and radiological signs of foreign body aspiration in South Indian children. Materials and methods We conducted this prospective cross-sectional study for one year in the Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Pondicherry, India in 56 cases. Our study included children younger than 14 years attending our hospital with a history of foreign body aspiration with or without respiratory distress, suspected cases of foreign body aspiration showing evidence of unilateral hyperinflation with or without evidence of collapse of the opposite lungs on chest X-ray (posterior-anterior view), and unexplained cough associated with X-ray evidence of unilateral hyperinflation or bronchiectasis. Emergency and elective rigid bronchoscopy were performed as per the clinical scenario, and patients were discharged from the hospital after stabilization. They were asked to return for two-week, three-month, and six-month follow-up evaluations. Results The most common age group of patients with foreign body aspiration was six to 18 months old. A definite history of foreign body aspiration was obtained in only 32 patients (57%). Most patients (n = 22; 68.75%) presented to the hospital within one to seven days of the foreign body aspiration. Respiratory distress was the most common clinical feature, present in 96% of our patients. The most common radiographic feature in our study was obstructive emphysema, seen in 33 patients (58.9%). Foreign bodies were retrieved from 40 patients (71.4%), and no foreign body could be found via bronchoscopy in 16 patients. The most common foreign body was groundnut (n = 27; 67.5%). Only four patients had inorganic foreign bodies. The most common site of aspirated foreign bodies was the right main bronchus (n = 14; 35%). Only two patients (3.57%) had persistent pneumonia that cleared up radiologically after three months and was culture negative for bacteria. Conclusions Strong clinical suspicion of foreign body aspiration based on history and early bronchoscopy can reduce the morbidity and mortality due to foreign body aspiration in children.