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Foreign body aspiration in children: experience from Ethiopia
1Department of Surgery, Faculty of Medicine, Addis Ababa University, Ethiopia.
Insights
Foreign body aspiration (FBA) in children often presents late, leading to delayed diagnosis and high mortality. Early consideration and prompt bronchoscopic intervention are crucial for better outcomes in pediatric FBA cases.
Area of Science:
- Pediatric Pulmonology
- Emergency Medicine
- Otolaryngology
Background:
- Foreign body aspiration (FBA) is a significant cause of respiratory distress and mortality in children.
- Timely diagnosis and intervention are critical for managing pediatric FBA.
Purpose of the Study:
- To analyze the clinical characteristics, management, and outcomes of pediatric foreign body aspiration.
- To identify factors contributing to morbidity and mortality in FBA cases.
- To emphasize the importance of early diagnosis and intervention.
Main Methods:
- Retrospective review of 79 children treated for FBA over seven years (1987-1994).
- Analysis of patient demographics, presentation time, diagnostic history, radiologic findings, and interventions.
- Evaluation of bronchoscopic procedures, outcomes, and mortality causes.
Main Results:
- Mean age of patients was 3.4 years, with a male predominance (55 boys, 24 girls).
- Only 19% presented within 24 hours; 20% had delayed or missed diagnoses.
- Bronchoscopic extraction was successful in most cases, but 11% of children died due to late presentation and diagnostic delays.
Conclusions:
- Late presentation, delayed diagnosis, and intervention significantly increase morbidity and mortality in pediatric FBA.
- Early consideration of FBA in unexplained pulmonary issues and prompt bronchoscopy are vital.
- Reducing mortality requires timely diagnosis and efficient bronchoscopic foreign body extraction.
Abstract:
Seventy-nine children with foreign body aspiration (FBA) were treated at the Ethio-Swedish Children's Hospital in Addis Ababa, Ethiopia, over a seven year period, from September 1987 to August 1994. There were 55 boys and 24 girls with a mean age of 3.4 years. Only 15 (19%) children presented within 24 hours of aspiration. A definite or suggestive history of FBA was obtained in 68 (86%) children. Abnormal radiologic findings were present in 60 (76%) cases. Correct diagnosis was delayed or missed in 16 (20%) cases. Bronchoscopic extraction of foreign bodies was made in 62 out of 69 bronchoscoped cases. Three children coughed up the foreign bodies spontaneously. Nine (11%) children died, six before, two during and one after bronchoscopy. Late presentation, delay in diagnosis and intervention as well as missed diagnosis were major causes of prolonged morbidity and high mortality. Considering FBA early in the differential diagnosis of unexplained pulmonary problems, early bronchoscopy for such cases and prompt bronchoscopic extraction of aspirated foreign bodies are stressed to reduce and eventually avoid the high morbidity and mortality associated with FBA in children.