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Published on: September 11, 2018
Occult foreign body aspirations in pediatric patients: 20-years of experience
Bo Liu1,2, Fengxia Ding3,4, Yong An5
1Department of Cardiothoracic Surgery; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, No. 136, Zhongshan 2nd Road, Yuzhong Dis, Chongqing, 400014, China. lbcqmu@126.com.
Background:
The purpose of our study was to assess the frequency of occult foreign body aspiration (FBA) and to evaluate the diagnostic difficulties and therapeutic methods for these patients.
Methods:
Between May 2000 and May 2020, 3557 patients with the diagnosis of FBA were treated in our department. Thirty-five patients with occult FBA were included in this study. A retrospective analysis of medical records was performed.
Results:
Twenty-three male patients (65.7%) and 12 female patients (34.3%) were hospitalized due to occult FBA. The average age was 3.60 years (range 9 months-12 years). Most of the patients were younger than 3 years old (n = 25, 71.4%). Coughing (n = 35, 100%) and wheezing (n = 18, 51.4%) were the main symptoms and signs. All the patients were found to have a FBA under the fiberoptic bronchoscope. The most common organic foreign bodies were peanuts (n = 10) and the most common inorganic foreign bodies were pen caps (n = 5). The extraction of foreign bodies under rigid bronchoscopy was applied successfully in 34 patients. Only one patient needed a surgical intervention.
Conclusions:
Occult FBA should always be considered in the differential diagnosis of chronic or recurrent respiratory diseases that are poorly explained, even in the absence of a previous history of aspiration.
Insights
Occult foreign body aspiration (FBA) is often missed in children with respiratory issues. Early diagnosis and bronchoscopic removal are key to successful treatment, even without a clear aspiration history.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Diagnostic Challenges
Background:
- Occult foreign body aspiration (FBA) presents diagnostic challenges in pediatric respiratory cases.
- Understanding the frequency and characteristics of occult FBA is crucial for timely intervention.
Purpose of the Study:
- To determine the incidence of occult foreign body aspiration (FBA).
- To evaluate diagnostic difficulties associated with occult FBA.
- To assess therapeutic strategies for patients with occult FBA.
Main Methods:
- Retrospective analysis of 35 patients diagnosed with occult FBA between May 2000 and May 2020.
- Inclusion criteria focused on patients with confirmed FBA and diagnostic challenges.
- Data collection involved medical record review.
Main Results:
- Occult FBA predominantly affected young children (71.4% under 3 years), with a male predominance (65.7%).
- Coughing (100%) and wheezing (51.4%) were the primary presenting symptoms.
- Peanuts and pen caps were the most common foreign bodies; rigid bronchoscopy achieved successful extraction in 34 of 35 patients.
Conclusions:
- Occult FBA should be considered in unexplained chronic or recurrent respiratory conditions in children.
- Even without a history of aspiration, FBA must be in the differential diagnosis.
- Prompt diagnosis and bronchoscopic intervention lead to high success rates.
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