The Diagnostic Challenge of Sharp Foreign Body Aspiration in Children: A Two-Case Series Highlighting Ingestion vs....

Area of Science:

• Pediatric Emergency Medicine
• Otolaryngology
• Pulmonology

Background:

• Foreign body aspiration (FBA) is a frequent pediatric emergency.
• Sharp objects like pins present unique risks of perforation and migration.
• Distinguishing aspiration from ingestion is difficult with overlapping symptoms and imaging, particularly for mediastinal foreign bodies.

Purpose of the Study:

• To present two cases of sharp foreign body aspiration in school-aged children.
• To highlight diagnostic challenges and management strategies for sharp FBA.
• To emphasize the importance of a high index of suspicion for this preventable hazard.

Main Methods:

• Case report series of two school-aged children with sharp foreign body aspiration.
• Diagnostic imaging (Chest X-ray) and endoscopic procedures (rigid and flexible bronchoscopy) were utilized.
• Surgical removal of aspirated sharp foreign bodies.

Main Results:

• Sharp foreign bodies (headscarf pin, sewing needle) were successfully retrieved via bronchoscopy in school-aged children.
• Aspiration presented with acute chest pain in one case and delayed hemoptysis in another.
• Mediastinal foreign body location created a diagnostic dilemma, requiring sequential endoscopic evaluation.

Conclusions:

• Sharp foreign body aspiration can occur in older children and may have delayed or atypical presentations.
• Radiological findings of mediastinal foreign bodies necessitate a high index of suspicion for aspiration.
• Tailored endoscopic approaches (rigid vs. flexible bronchoscopy) are essential for effective foreign body removal.