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Endobronchial foreign body in children: can it be predictable?
Corentin Stavart1, Eddy Bodart2
1Department of Paediatrics, CHU UCL Namur Godinne, Yvoir, Belgium; Department of Paediatrics, Cliniques universitaires Saint-Luc, Brussel, Belgium; Pole of Lung, Nose and Skin (LUNS), Institute of Experimental and Clinical Research (IREC), Université catholique de Louvain (UCLouvain), Brussels, Belgium.
Summary
Foreign body aspiration in children is common, particularly in toddlers. Clinical signs like asymmetric auscultation and radiological findings such as unilateral hyperinflation aid diagnosis, with bronchoscopy crucial for confirmation and treatment.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Medicine
- Diagnostic Imaging
Background:
- Foreign body aspiration (FBA) is a critical pediatric emergency.
- Diagnosis is challenging due to varied presentations.
- Rigid bronchoscopy, while effective, has a high rate of negative procedures.
Purpose of the Study:
- To analyze clinical, radiological, and procedural data for suspected FBA in children.
- To identify key diagnostic predictors and outcomes.
- To evaluate the role of bronchoscopy in FBA management.
Main Methods:
- Retrospective review of paediatric bronchoscopies for suspected FBA over 30 years.
- Analysis of symptomatology, foreign body characteristics, and follow-up outcomes.
- Data from CHU UCL Namur, Godinne, Belgium.
Main Results:
- FBA confirmed in 59% of 99 bronchoscopies; highest incidence in 1-3 year olds.
- Penetration syndrome (90% sensitivity) and asymmetric auscultation (98% specificity) were strong indicators.
- Unilateral hyperinflation (88% specificity) was the most specific radiological sign; nuts were the most common FBA.
- Complications occurred in 48% per-procedure and 35% post-procedure, with no fatalities.
Conclusions:
- Diagnosis of FBA requires a combination of clinical examination, history, and imaging.
- Both rigid and flexible bronchoscopy are essential for FBA diagnosis and management.
- Complete clinical recovery was achieved in all patients at 6-month follow-up.
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