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[Foreign bodies in the airways and esophagus in children]
1Ore-naese-halsafdelingen, Amtssygehuset i Glostrup.
Insights
Foreign bodies in children's airways or esophagus are a serious risk. Prompt rigid esophagoscopy and bronchoscopy are crucial for recovery, and small items should be kept from children.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Pulmonology
- Emergency Medicine
Context:
- Foreign body ingestion and aspiration are common pediatric emergencies.
- Airway and esophageal foreign bodies present significant risks, including mortality.
- Understanding the epidemiology and clinical presentation is vital for timely intervention.
Purpose:
- To review the occurrence, clinical course, and mortality of airway and esophageal foreign bodies in children.
- To analyze the common symptoms, diagnostic findings, and causative agents.
- To estimate the mortality rate associated with airway foreign bodies in children.
Summary:
- A review of 99 children with airway (n=51) or esophageal (n=48) foreign bodies revealed key differences in presentation and risk factors.
- Airway foreign bodies predominantly affected 1-3 year olds with choking history, presenting with cough, wheezing, and cyanosis; nuts were the most common extracted object.
- Esophageal foreign bodies occurred in a similar number of children, with a notable incidence of respiratory symptoms.
Impact:
- Highlights the importance of prompt rigid esophagoscopy and bronchoscopy for diagnosis and treatment.
- Provides an estimated mortality rate of 0.9 per 100,000 children annually for airway foreign bodies in Denmark.
- Emphasizes the need for parental awareness regarding the safe storage of small objects like nuts and tablets to prevent childhood foreign body incidents.
Abstract:
The hospital records of 99 children with foreign bodies in the airways (n = 51) or oesophagus (n = 48) were reviewed with respect to occurrence, course of disease and mortality. Childhood death records in Denmark over a ten year period due to asphyxiation by food were surveyed. A third of the patients with oesophageal foreign bodies had respiratory symptoms. Most children with airway foreign bodies were aged 1 to 3 years and generally had a positive history of choking. The dominating symptoms were cough, wheezing and cyanosis. Chest X-ray was normal in 25%. There were no complications during bronchoscopy. The most common foreign bodies extracted were nuts (29%). The estimated death rate due to airway foreign bodies is 0.9 per 100,000 children in Denmark per year. Rigid oesophagoscopy and bronchoscopy should be performed promptly on suspicion of foreign bodies located in the oesophagus or airways to ensure fast recovery. Nuts, tablets and other small items should not be within reach of small children.