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Foreign Body Aspiration in Egyptian Children Clinical, Radiological and Bronchoscopic Findings
Heba M Reyad1, Mohamed E El-Deeb2, Ahmed M Abbas1
1Department of Pediatrics, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt.
Insights
Diagnosing foreign body aspiration in children is difficult without a witnessed event. Clinical signs like cough and wheezing, along with symptoms, can help predict aspiration and guide bronchoscopy decisions.
Area of Science:
- Pediatric Pulmonology
- Otolaryngology
- Diagnostic Accuracy
Background:
- Foreign body aspiration (FBA) is a significant cause of illness and death in children.
- Diagnosing FBA is challenging, especially when the aspiration event is not observed.
Purpose of the Study:
- To evaluate the predictive accuracy of symptoms, physical, and radiological findings for FBA in children.
- To establish clearer indications for performing bronchoscopy in suspected pediatric FBA cases.
Main Methods:
- Retrospective cohort study of 130 pediatric patients (<16 years) undergoing rigid bronchoscopy for suspected FBA.
- Data collected included demographics, symptoms, physical exam findings, radiology, foreign body characteristics, and bronchoscopy outcomes.
Main Results:
- A foreign body was confirmed in 80.8% of patients.
- The right main bronchus was the most common location (43.8%), with nuts being the most frequent foreign body (66.7%).
- Multivariate analysis identified suggestive signs/symptoms as independent predictors of FBA.
Conclusions:
- Objective clinical signs (e.g., unilateral wheezing) combined with symptoms (cough, dyspnea, hoarseness) can predict FBA.
- These findings aid physicians in determining the necessity of bronchoscopy for pediatric FBA.
Purpose:
Foreign body aspiration (FBA) is a frequent cause of childhood morbidity and mortality. Diagnosis of FBA is challenging in the absence of a witnessed aspiration event. The aim of this study was to determine the accuracy of presenting symptoms as well as physical and radiologic findings as predictors of FBA in children. Thus, indications for bronchoscopy could be determined in such cases.
Methods:
This retrospective cohort study was conducted in the ENT department, Kafr-elsheikh University Hospital. The medical records of patients younger than 16 years old who underwent rigid bronchoscopy for suspected FBA were included. Data including age, gender, symptoms, physical examination findings, radiological features, nature and location of foreign body, and outcome of the bronchoscopy were collected.
Results:
This study included 130 patients, 105 (80.8%) patients were positive for the presence of a foreign body in their airways. Foreign bodies were most frequently (43.8%) lodged in the right main bronchus, and nuts (66.7%), were the most commonly retrieved. Multivariate regression analysis identified the presence of suggestive signs or symptoms as independent predictors of FBA on rigid bronchoscopy.
Conclusion:
Objective finding of clinical signs eg unilateral wheezes on chest examination in the presence of symptoms such as a sudden cough, dyspnea, and hoarseness could predict FBA and help physicians in deciding bronchoscopy.
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