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Inhalation of foreign bodies by children: a continuing challege in management
Insights
Pediatric foreign body aspiration, often presenting as sudden wheezing or coughing, requires prompt bronchoscopic removal. Early intervention ensures safe outcomes, preventing long-term disability in children.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Otolaryngology
Background:
- Inhalation of foreign bodies is a significant cause of respiratory distress in young children.
- Timely diagnosis and intervention are crucial for preventing complications.
- Commonly aspirated objects include food items like nuts and beans.
Purpose of the Study:
- To review a 19-year experience with pediatric foreign body aspiration.
- To identify common presenting symptoms, types of aspirated objects, and treatment outcomes.
- To emphasize the preferred management strategy for foreign body inhalation in children.
Main Methods:
- Retrospective review of 33 pediatric patients treated for foreign body aspiration over 19 years.
- Analysis of presenting symptoms, radiological findings, types of foreign bodies, and procedural outcomes.
- All patients underwent bronchoscopy for diagnosis and foreign body removal.
Main Results:
- The most frequent symptoms were recent onset wheezing and/or coughing, with decreased air entry.
- Commonly inhaled objects included nuts, peas, and beans (18 cases), alongside other organic/inorganic items (15 cases).
- Complete removal was achieved in 19 patients during the initial bronchoscopy; others required repeat procedures or surgery. No permanent disability or death occurred.
Conclusions:
- Foreign body aspiration in children typically presents with acute respiratory symptoms.
- Bronchoscopy is an effective and safe method for diagnosing and removing inhaled foreign bodies.
- Early bronchoscopic removal is the recommended treatment to ensure favorable outcomes and prevent complications.
Abstract:
In a review of 19 years' experience with inhalation of foreign bodies by children the 33 patients (mean age 28 months) were found to have presented most frequently with wheezing or coughing, or both, of recent onset, and to have decreased air entry, rhonchi or respiratory stridor, or a combination of these signs. Eighteen children had inhaled a nut, a pea or a bean. The other 15 had inhaled various organic and inorganic objects. All the children underwent bronchoscopy, and the foreign body was completely removed in 19 during the first procedure; the remainder required repeated bronchoscopy or direct surgical removal of the foreign body, or both. Permanent disability or death was not encountered. The findingsof the study indicate that early bronchoscopic removal is the preferred treatment when a child inhales a foreign body.