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Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children
04:55

Handheld Metal Detector Screening for Metallic Foreign Body Ingestion in Children

Published on: September 11, 2018

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Principal diagnostic features of paediatric foreign body aspiration

Emily Lowe1, Erdinc Soylu1, Praveena Deekonda1

  • 1ENT Department, Southampton Children's Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, S016 6YD, United Kingdom.

International Journal of Pediatric Otorhinolaryngology
|January 4, 2024
PubMed

Insights

A cough history and radiographic hyperinflation are key indicators of foreign body aspiration in children. A witnessed choking episode alone is not a reliable predictor, emphasizing the need for combined clinical and radiological assessment.

Area of Science:

  • Pediatric Pulmonology
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Foreign body aspiration is a significant cause of respiratory distress in children.
  • Accurate diagnosis is crucial for timely intervention and preventing complications.
  • Diagnostic bronchoscopy is often required but carries risks and costs.

Purpose of the Study:

  • To identify key clinical and radiographic features associated with foreign body aspiration in pediatric patients.
  • To aid in rationalizing the decision-making process for diagnostic bronchoscopy.
  • To improve diagnostic accuracy and resource allocation in suspected foreign body aspiration cases.

Main Methods:

  • Retrospective review of 70 pediatric patients over 12 years at a tertiary referral center.
  • Documentation of presenting history, clinical examination findings, and chest radiograph results.
  • Univariate logistic regression analysis to determine odds ratios for identified features.

Main Results:

  • A history of cough (OR 5.1) and radiographic evidence of hyperinflation or air trapping (OR 7.1) were significantly associated with confirmed foreign body aspiration.
  • A witnessed choking episode alone did not increase the likelihood of foreign body aspiration (OR 1).
  • No patients with foreign body aspiration presented solely with a positive history without other clinical or radiological signs.

Conclusions:

  • Cough and radiographic hyperinflation are the most important indicators of pediatric foreign body aspiration.
  • Relying solely on a history of witnessed choking is insufficient for diagnosing foreign body aspiration.
  • Integrated assessment of clinical history and radiographic findings is essential for guiding decisions on diagnostic bronchoscopy.
Abstract

Keywords:
AspirationBronchoscopyCoughForeign body

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